Total repair of tetralogy of Fallot in the adult

ABSTRACT

Between 1951 and 1981, 13 adult patients underwent total intracardiac repair of tetralogy of Fallot at the Cleveland Clinic. Mean age at the time of repair was 29.4 years (range 18—44 years). Eighty-five percent of the patients were classified preoperatively as New York Heart Association Functional Class III or IV. Three of the patients had had no previous palliation. Mean duration of follow-up was 49.4 months. There was no early or late mortality. Postoperatively all patients experienced a dramatic fall in right ventricular systolic pressure with no right ventricular outflow tract gradient. Postoperative arrhythmias severe enough to require treatment occurred in only two patients. These findings suggest that an aggressive surgical approach can be undertaken in adults with uncorrected tetralogy of Fallot.