Cited by 264Congenital Heart Disease StudiesCongenital heart defects researchCardiac Valve Diseases and Treatments

Reoperation in adults with repair of tetralogy of Fallot: indications and outcomes.

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Oechslin, Erwin N., Harrison, David A., Harris, Louise, Downar, Eugene, Webb, Gary D., Siu, Samuel S., Williams, William G.·1999·The Journal of Thoracic and Cardiovascular Surgery

Abstract

Objective The purpose of this study is to review indications, surgical procedures, and outcomes in adults with repaired tetralogy of Fallot referred for reoperation.Method Sixty consecutive adults (age >/= 18 years) who underwent reoperation between 1975 and 1997 after previous repair of tetralogy of Fallot were reviewed. Mean age at corrective repair was 13.3 +/- 9.6 years and at reoperation 33.3 +/- 9.6 years. Mean follow-up after reoperation is 5.0 +/- 4.9 years.Results Long-term complications of the right ventricular outflow tract (n = 45, 75%) were the most common indications for reoperation: severe pulmonary regurgitation (n = 23, 38%) and conduit failure (n = 13, 22%) were most frequent. Less common indications were ventricular septal patch leak (n = 6) and severe tricuspid regurgitation (n = 3). A history of sustained ventricular tachycardia was present in 20 patients (33%) and supraventricular tachycardia occurred in 9 patients (15%). A bioprosthetic valve to reconstruct the right ventricular outflow tract was used in 42 patients. Additional procedures (n = 115) to correct other residual lesions were required in 46 patients (77%). There was no perioperative mortality. Actuarial 10-year survival is 92% +/- 6%. At most recent follow-up, 93% of the patients are in New York Heart Association classification I or II. Sustained ventricular tachycardia occurred in 4 patients (7%) during follow-up.Conclusions Long-term complications of the right ventricular outflow tract were the main reason for reoperation. Mid-term survival and functional improvement after reoperation are excellent.

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Crossref · 10.1016/s0022-5223(99)70214-x

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  • Right ventricle dilatation usually prompts the replacement of the native pulmonary valve at some time during follow-up, with the burden of redo operations every 10 to 15 years thereafter.

    “Right ventricle dilatation therefore usually prompts the replacement of the native pulmonary valve at some time during follow-up, with the burden of redo operations every 10 to 15 years thereafter.12,13”

    From Comparison of Long-term Outcomes of Valve-Sparing and Transannular Patch Procedures for Correction of Tetralogy of Fallot (2021) · cites this paper as [12]

    The Indication for reoperation section says increasing right ventricular dilatation, usually accompanied by symptoms or arrhythmia, was a reason to consider surgery for pulmonary regurgitation. The Discussion reports that 86% of patients with a pulmonary bioprosthesis were free of valve reoperation at 10 years; it does not support a routine need for redo operations every 10–15 years. Page numbers are unavailable in our copy. (LLM, conf=0.88)

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Authors
Oechslin, E. N., Harrison, D. A., Harris, L., Downar, E., Webb, G. D., Siu, S. S., & Williams, W. G.
Affiliations
University of Zurich (CH)
Venue
The Journal of Thoracic and Cardiovascular Surgery
Publisher
Elsevier BV
Published
1999-08
Volume
118
Issue
2
Pages
245-251
ISSN
0022-5223 (ISSN-L)
OpenAlex
W2127391441
Cited by
264
References
32
Citations by year
2026: 1 · 2025: 4 · 2024: 4 · 2023: 7 · 2022: 5 · 2021: 8 · 2020: 12 · 2019: 7 · 2018: 6 · 2017: 5 · 2016: 7 · 2015: 10 · 2014: 12 · 2013: 13 · 2012: 15
FWCI
7.95
Type
journal article
Language
en
Open access
Locations
  • Journal of Thoracic and Cardiovascular Surgery (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Epidemiology › Congenital Heart Disease Studies
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Congenital heart defects research
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Valve Diseases and Treatments
Keywords
tetralogy of Fallot, reoperation, adult congenital heart disease, right ventricular outflow tract, pulmonary regurgitation, conduit failure, tricuspid regurgitation, ventricular tachycardia, bioprosthetic heart valves, long-term survival, surgical outcomes
MeSH terms
Adolescent, Adult, Child, Child, Preschool, Cryosurgery, Female, Follow-Up Studies, Cardiac Surgical Procedures, Humans, Male, Middle Aged, Ontario, Postoperative Complications, Pulmonary Valve Insufficiency, Reoperation, Retrospective Studies, Tachycardia, Tetralogy of Fallot, Ventricular Outflow Obstruction, Survival Rate, Treatment Outcome

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