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

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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

DOI 10.1016/s0022-5223(99)70214-x

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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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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)
ORCID: Oechslin, Erwin N.
Harris, Louise
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)
DOI: 10.1016/s0022-5223(99)70214-x
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: bronze
doi.org
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
www.elsevier.com/open-access/userlicense/1.0/ (vor, 6184 d)
Locations: Journal of Thoracic and Cardiovascular Surgery (publishedVersion)
PubMed (publishedVersion)
Topics: Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › 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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Reoperation in adults with repair of tetralogy of Fallot: indications and outcomes.

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