Seminars in Thoracic and Cardiovascular Surgery: Pediatric Cardiac Surgery Annual
Volume 3, Issue 1 , Pages 216-226 , January 2000

Tetralogy of Fallot: Late outcome after repair and surgical implications

References 

  1. Fallot A. Contribution a l'anatomie pathologique de la maladie bleue (cyanose cardiaque). Marseille Med. 1888;25:77–93
  2. Lev M, Eckner FAO. The pathologic anatomy of tetralogy of Fallot and it's variations. Dis Chest. 1964;45:251–261
  3. Goor DA, Lillehei CW, Edwards JE. Ventricular septal defects and pulmonic stenosis with and without dextroposition. Anatomic features and embryonic implications. Chest. 1971;60:117–128
  4. Freedom RM, Mawson JB, Yoo S-J, et al.  The absent pulmonary valve: Tetralogy of Fallot and other variants, in Congenital Heart Disease Textbook of Angiography. In: Armonk, NY: Futura; 1997;p. 597–615
  5. Berry TE, McGoon DC. Total correction of tetralogy of Fallot with anomalous coronary artery. Surgery. 1973;74:894–897
  6. Hawe A, Rastelli GC, Ritter DG, et al.  Management of the right ventricular outflow tract in severe tetralogy of Fallot. J Thorac Cardiovasc Surg. 1970;60:131–143
  7. Betranou EG, Blackstone EH, Hazelrig JB, et al.  Life expectancy without surgery in tetralogy of Fallot. Am J Cardiol. 1978;42:458–466
  8. Kirklin JK, Barratt-Boyes BG. Ventricular septal defect and pulmonary stenosis or atresia. In:  Kirklin JK,  Barratt-Boyes BG editor. Cardiac Surgery. New York, NY: Churchill Livingstone; 1993;p. 884–885
  9. Jones M, Ferrans VJ. Myocardial degeneration in congenital heart disease: Comparison of morphological findings in young and old patients with congenital heart disease associated with muscular obstruction to the right ventricular outflow. Am J Cardiol. 1977;39:1051–1063
  10. Hegerty A, Anderson RH, Deanfield JE. Myocardial fibrosis in tetralogy of Fallot: Effect of surgery or part of the natural history. Br Heart J. 1988;59:123
  11. Deanfield JE, Ho SY, Anderson RH, et al.  Late sudden death after repair of tetralogy of Fallot: A clinicopathological study. Circulation. 1983;67:626–631
  12. Wessel HU, Bastanier CK, Paul MH, et al.  Prognostic significance of arrhythnia in tetralogy of Fallot after intracardiac repair. Am J Cardiol. 1980;46:843–848
  13. Sullivan ID, Presbitero P, Cooch VM, et al.  Is ventricular arrhythmia in repaired tetralogy of Fallot an effect of operation or a consequence of the course of disease?. Br Heart J. 1987;58:40–44
  14. Oechslin EN, Harrison DA, Harris L, et al.  Reoperation in adults with repair of tetralogy of Fallot: Indications and outcomes. J Thorac Cardiovasc Surg. 1999;118:245–251
  15. de Leval MR, McKay R, Jones M, et al.  Modified Blalocktaussig shunt: Use of subclavian artery orifice as flow regulator in prosthetic systemic-pulmonary artery shunts. J Thorac Cardiovasc Surg. 1981;81:112–119
  16. Kirklin JW, Blackstone EH, Kirklin JK, et al.  Surgical results and protocols in the spectrum of tetralogy of Fallot. Ann Surgery. 1983;45:231–233
  17. Qureshi SA, Kirk CR, Lamb RK, et al.  Balloon dilatation of the pulmonary valve in the first year of life in patients with tetralogy of Fallot: A preliminary study. Br Heart J. 1988;60:232–235
  18. Godart F, Rey C, Prat A, et al.  Early and late results and the effects on pulmonary arteries of balloon dilatation of the right ventricular outflow tract in tetralogy of Fallot. Eur Heart J. 1998;19:595–600
  19. Sluysman T, Neven B, Rubay J, et al.  Early balloon dilatation of the pulmonary valve in infants with tetralogy of Fallot: Risks and benefits. Circulation. 1995;91:1506–1511
  20. Battistessa SA, Robles A, Jackson M, et al.  Operative findings after percutaneous pulmonary balloon dilatation of the right ventricular outflow tract in tetralogy of fallot. Br Heart J. 1990;64:321–324
  21. Lillehei CW, Cohen M, Warden HE, et al.  Direct vision intracardiac surgical correction of the tetralogy of Fallot, peritalogy of Fallot, and pulmonary atresia defects; report of first ten cases. Ann Surg. 1955;142:418–445
  22. Kirklin JW, DuShane JW, Patrick RT, et al.  Intracardiac surgery with the aid of a mechanical pump-oxygenator system (Gibbon type): Report of eight cases. Mayo Clin Proc. 1955;30:201
  23. Warden HE, DeWall RA, Cohen M, et al.  A surgical pathologic classification for isolated ventricular septal defects and for those in Fallot's tetralogy based on observations made on 120 patients during repair under direct vision. J Thorac Surg. 1957;33:21
  24. Kirklin JW, Ellis FH, McGoon DC, et al.  Surgical treatment for tetralogy of Fallot by open intracardiac repair. J Thorac Surg. 1959;37:22
  25. Hudspeth AS, Cordell AR, Johnston FR. Transatrial approach to total correction of tetralogy of Fallot. Circulation. 1963;27:796–800
  26. Ross DN, Somerville J. Correction of pulmonary atresia with a homograft aortic valve. Lancet. 1966;2:1446
  27. d'Udekem Y, Rubay J, Shango-Lody P, et al.  Late homograft valve insertion after transannular patch repair of tetralogy of Fallot. J Heart Valve Surg. 1998;7:450–454
  28. Barratt-Boyes BG, Neutze JM. Primary repair of tetralogy of Fallot in infancy using profound cardiopulmonary bypass: A comparison with conventional two stage management. Ann Surg. 1973;178:406–421
  29. Fink SJ, Puga FJ, Danielson GK. Pulmonary valve insertion during reoperation for tetralogy of Fallot. Ann Thorac Surg. 1988;45:610–613
  30. Castaneda AR, Freed MD, Williams RG, et al.  Repair of tetralogy of Fallot in infancy: Early and late results. J Thorac Cardiovasc Surg. 1977;74:372–381
  31. Reddy VM, Liddicoat JR, McElhinney DB, et al.  Routine repair of tetralogy of Fallott in neonates and infants less than three months of age. Ann Thorac Surg. 1995;60:S592–S596
  32. Karl TR, Porniviliwan S, Mee RBB. Tetralogy of Fallot: Favourable outcome of nonneonatal transatrial, transpulmonary repair. Ann Thorac Surg. 1992;54:903–907
  33. Stellin G, Milanesi O, Rubino M, et al.  Repair of tetralogy of Fallot in the first six months of life: Transatrial versus transventricular repair. Ann Thorac Surg. 1995;60:S588–S591
  34. Knott-Craig CJ, Elkins RC, Lane MM, et al.  A 26-year experience with surgical management of tetralogy of Fallot: Risk analysis for mortality or late reintervention. Ann Thorac Surg. 1998;66:506–511
  35. Seliem MA, Wu YT, Glenwright K. Relation between age at surgery and regression of right ventricular hypertrophy in tetralogy of Fallot. Pediatr Cardiol. 1999;16:53–55
  36. McLeod KA, Hillis WS, Houston AB, et al.  Reduced heart rate variability following repair of tetralogy of Fallot. Heart. 1999;81:656–660
  37. Walsh EP, Rockenmacher J, Keane JF, et al.  Late results in patients with tetralogy of Fallot repaired during infancy. Circulation. 1988;77:1062–1067
  38. Touati GD, Vouche PR, Amodeo A, et al.  Primary repair of tetralogy of Fallot in infancy. J Thorac Cardiovasc Surg. 1990;99:396–403
  39. Joffe H, Georgakopoulos D, Celermajer DS, et al.  Late ventricular arrhythmia is rare after early repair of tetralogy of Fallot. J Am Coll Cardiol. 1994;23:1146–1150
  40. Hennein HA, Mosca RS, Urcelay G, et al.  Intermediate results after complete repair of tetralogy of fallot in neonates. J Thorac Cardiovasc Surg. 1995;109:332–342
  41. Kaushal SK, Iyer KS, Sharma R, et al.  Surgical experience with total correction of tetralogy of Fallot in infancy. Int J Cardiol. 1996;56:35–40
  42. Volbecky SJ, Williams WG, Trusler GA, et al.  Survival analysis of infants under age 18 months presenting with tetralogy of Fallot. Ann Thorac Surg. 1993;56:944–949
  43. Wessel HU, Cunningham WJ, Paul MH, et al.  Exercise performance in tetralogy of Fallot after intracardiac repair. J Thorac Cardiovasc Surg. 1980;80:582–593
  44. Rowe SA, Zahka KG, Manolio TA, et al.  Lung function and pulmonary regurgitation limit exercise capacity in postoperative tetralogy of Fallot. J Am Coll Cardiol. 1991;17:461–466
  45. Carvalho JS, Shinebourne EA, Busst C, et al.  Exercise capacity after complete repair of tetralogy of Fallot: Deleterious effects of residual pulmonary regurgitation. Br Heart J. 1992;67:470–473
  46. DiDonato RM, Jonas RA, Lang P, et al.  Neonatal repair of tetralogy of Fallot with and without pulmonary atresia. J Thorac Cardiovasc Surg. 1991;101:126–137
  47. Antunes MJ, Castela E, Sanches ME, et al.  Preservation of the pulmonary annulus in total correction of tetralogy of Fallot: Decreasing transannular gradients in the early follow-up period. Eur J Cardiothorac Surg. 1991;5:533
  48. Vogt PR, Bauer EP, Von Segresser LK, et al.  Homograftmonocusp implantation Zur reconstruktion des rechtsventikularen ausflusstraktes bei der korrektur der Fallot-tetralogie. Schweiz Med Wochenschr. 1992;122:975–978
  49. Dietl CA, Cazzaniga ME, Dubner SJ, et al.  Life-threatening arrhythmias and RV dysfunction after surgical repair of tetralogy of Fallot. Comparison between transventricular and transatrial approaches. Circulation. 1994;2:I17–I112
  50. Miura T, Nakano S, Shimazaki Y, et al.  Evaluation of right ventricular function by regional wall motion analysis in patients after correction of tetralogy of Fallot. Comparison of transventricular and nontransventricular repairs. J Thorac Cardiovasc Surg. 1992;104:917–923
  51. Kavey R-EW, Bove EL, Byrum CJ, et al.  Postoperative functional assessment of a modified surgical approach to repair of tetralogy of Fallot. J Thorac Cardiovasc Surg. 1987;93:533–538
  52. Coles JG. Transatrial repair of tetralogy of Fallot. Ann Thorac Surg. 1995;59:1363; (editorial)
  53. Kawashima Y, Kitamura S, Nakano S, et al.  Corrective surgery for tetralogy of fallot without or with minimal right ventriculotomy and with repair of the pulmonary valve. Circulation. 1981;64:147–153
  54. Atallah-Yunes NH, Kavey R-EW, Bove EL, et al.  Postoperative assessment of a modified approach to repair of tetralogy of Fallot. Circulation. 1996;94:I122–I126
  55. Waien SA, Liu PP, Ross BL, et al.  Serial follow-up of adults with repaired tetralogy of Fallot. J Am Coll Cardiol. 1992;20:295–300
  56. Murphy JG, Gersh BG, Mair DD, et al.  Long-term outcome in patients undergoing surgical repair of tetralogy of Fallot. N Engl J Med. 1993;329:593–599
  57. Norgaard MA, Lauridsen P, Helvind M, et al.  Twenty-to-thirty-seven-year follow-up after repair of tetralogy of Fallot. Eur J Cardiothorac Surg. 1999;16:125–130
  58. Graham TP, Cordall D, Atwood GF, et al.  Right ventricular volume characteristics before and after palliative and reparative operation in tetralogy of Fallot. Circulation. 1976;54:417–423
  59. Redington AN, Oldershaw PJ, Shinebourne EA, et al.  A new technique for the assessment of pulmonary regurgitation and it's application to the assessment of right ventricular function before and after repair of tetralogy of Fallot. Br Heart J. 1988;60:57–65
  60. Streider DJ, Aziz KU, Zaver AG, et al.  Exercise tolerance after repair of tetralogy of Fallot. Ann Thorac Surg. 1975;19:397–406
  61. Tomassoni TL, Galloto FM, Vaccaro T. Cardiopulmonary exercise testing in children following surgery for tetralogy of Fallot. Am J Dis Child. 1991;145:1290–1293
  62. Wessel HU, Paul MH. Exercise studies in tetralogy of Fallot: A review. Pediatr Cardiol. 1999;20:39–47
  63. Gatzoulis MA, Clark AL, Cullen S, et al.  Right ventricular diastolic function 15-35 years after repair of tetralogy of Fallot: Restrictive physiology predicts superior exercise performance. Circulation. 1995;91:1775–1781
  64. Gatzoulis MA, Till JA, Somerville J, et al.  Mechano-electrical interaction in tetralogy of Fallot: QRS prolongation relates to right ventricular size and predicts malignant ventricular arrhythmias and sudden death. Circulation. 1995;92:231–237
  65. Cullen S, Shore D, Redington A. Characterization of right ventricular diastolic performance after complete repair of tetralogy of Fallot: Restrictive physiology predicts slow postoperative recovery. Circulation. 1995;91:1782–1789
  66. Norgard G, Gatzoulis MA, Moraes F, et al.  The relationship between type of outflow tract repair and postoperative right ventricular diastolic physiology in tetralogy of Fallot: Implications for long-term outcome. Circulation. 1996;94:3276–3281
  67. Rosing DR, Borer JS, Kent KM, et al.  Long-term haemodynamic and electrocardiographic assessment following operative repair of tetralogy of Fallot. Circulation. 1978;58:I209–I217
  68. Deanfield JE. Late ventricular arrhythmias occurring after repair of tetralogy of Fallot: Do they matter?. Int J Cardiol. 1991;101:126–137
  69. Roos-Heselink J, Perloth MG, Spitaels S. Atrial arrhythmias in adults after repair of tetralogy of Fallot. Correlations with clinical, exercise, and echocardiographic findings. Circulation. 1995;91:2214–2219
  70. Garson A, Nihill MR, McNamara DG, et al.  Status of the adult and child after repair of tetralogy of Fallot. Circulation. 1979;59:1232–1240
  71. Kavey R-EW, Blackman MS, Sondheimer HM. Incidence and severity of chronic ventricular dysrhythmias after repair of tetralogy of Fallot. Am Heart J. 1982;103:342–350
  72. Bricker JT. Sudden death and tetralogy of Fallot. Circulation. 1995;92:162–163
  73. Kulbertus HE, Coyne JJ, Hallidie-Smith KA. Conduction disturbances before and after surgical closure of ventricular septal defect. Am Heart J. 1969;77:123–131
  74. Downing JW, Kaplan S, Bove KE. Postsurgical left anterior hemiblock and right bundle branch block. Br Heart J. 1972;34:263–270
  75. Malm JR, Gersony WM. Postoperative left anterior hemiblock and right bundle branch block following repair of tetralogy of Fallot: Clinical and aetiological considerations. Circulation. 1975;51:1026–1029
  76. Cullen S, Celermajer DS, Franklin RC, et al.  Prognostic significance of ventricular arrhythmia after repair of tetralogy of Fallot: A 12 year prospective study. J Am Coll Cardiol. 1994;23:1151–1155
  77. Gatzoulis MA, Balaji S, Webber SA, et al.  Clinical arrhythmia and sudden death in repaired tetralogy of Fallot: A multi-centre study. J Am Coll Cardiol. 1998;31(suppl):355A
  78. Kobayashi J, Hirose H, Nakano S, et al.  Ambulatory electrocardiographic study of the frequency and cause of ventricular arrhythmia after correction of tetralogy of Fallot. Am J Cardiol. 1984;54:1310–1313
  79. Katz NM, Blackstone EH, Kirklin JK, et al.  Late survival and symptoms after repair of tetralogy of Fallot. Circulation. 1982;65:403–410
  80. Kugler JD, Pinsky WW, Cheatham JP, et al.  Sustained ventricular tachycardia after repair of Fallot: New electrophysiological findings. Am J Cardiol. 1983;51:1137–1143
  81. Kavey R-EW, Thomas FD, Byrum CJ, et al.  Ventricular arrhythmias and biventricular dysfunction after repair of tetralogy of Fallot. J Am Coll Cardiol. 1984;4:126–131
  82. Burns R, Liu PP, Druck M. Analysis of adults with and without complex ventricular arrhythmia after repair of tetralogy of Fallot. J Am Coll Cardiol. 1984;4:226–233
  83. Harrison DA, Harris L, Siu SS, et al.  Sustained ventricular tachycardia in adults patients late after repair of tetralogy of Fallot. J Am Coll Cardiol. 1997;30:1368–1373
  84. Marie P-Y, Marcon F, Brunotte F, et al.  Right ventricular overload and induced sustained ventricular tachycardia in operatively “repaired” tetralogy of Fallot. Am J Cardiol. 1992;69:785–789
  85. Gatzoulis MA, Till JA, Redington AN. Depolarisation-repolarisation inhomogeneity after repair of tetralogy of Fallot: The substrate for malignant ventricular tachycardia?. Circulation. 1997;95:401–404
  86. Till JA, Gatzoulis MA, Deanfield JE, et al.  Evolution of QRS prolongation following repair of tetralogy of Fallot: Implications for symptomatic arrhythmia and sudden death. Circulation. 1995;92(suppl):I-707
  87. Perloff JK, Natterson PD. Atrial arrhythmias in adults after repair repair of tetralogy of fallot. Circulation. 1995;91:2118–2119
  88. Yemets IM, Williams WG, Webb GD, et al.  Pulmonary valve replacement late after repair of tetralogy of Fallot. Ann Thorac Surg. 1997;64:526–530
  89. Warner KG, Anderson JE, Fulton DR, et al.  Restoration of the pulmonary valve reduces right ventricular volume overload after previous repair of tetralogy of Fallot. Circulation. 1993;88:II189–II197
  90. Ilbawi MN, Idriss FS, DeLeon SY, et al.  Factors that exaggerate the deleterious effects of pulmonary insufficiency on the right ventricle after tetralogy repair. J Thorac Cardiovasc Surg. 1987;93:36–44
  91. Chaturvedi RR, Kilner P, White P, et al.  Increased airway pressure and simulated branch pulmonary stenosis increase pulmonary regurgitation after repair of tetralogy of Fallot: Real-time analysis using conductance catheter technique. Circulation. 1997;95:643–649
  92. Elliott J, Guru V, Gatzoulis MA, et al.  Ten-year follow-up of adults with repaired tetralogy of Fallot with serial RNA. J Am Coll Cardiol. 1998;31(suppl):287
  93. Therrien J, Siu SS, Harris L, et al.  The fate of clinical arrhythmia following pulmonary valve replacement after repair of tetralogy of Fallot: A multicenter study. Can J Cardiol. 1999;
  94. Bove EL, Byrum CJ, Thomas FD, et al.  The influence of pulmonary insufficiency on ventricular function following repair of tetralogy of Fallot. J Thorac Cardiovasc Surg. 1983;85:691–696
  95. Rosti L, Murxi B, Colli AM, et al.  Mechanical valves in the pulmonary position: A reappraisal. J Thorac Cardiovasc Surg. 1998;115:1074–1079

☆ Address reprint requests to Michael A. Gatzoulis, MD, PhD, FACC, Royal Brompton Hospital, Sydney St, London, SW3 6NP, UK.

PII: S1092-9126(00)70020-2

Seminars in Thoracic and Cardiovascular Surgery: Pediatric Cardiac Surgery Annual
Volume 3, Issue 1 , Pages 216-226 , January 2000

Article Tools