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Reoperation in adults with repair of tetralogy of Fallot: indications and outcomes.
Open accessAbstract
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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“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]
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Metadata
- 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
- bronze
- doi.org
- Licence
- 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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