eMedicine Specialties > Cardiology > Congenital Heart Disease in the Adult

Tetralogy of Fallot: Follow-up

Author: Shabir Bhimji, MD, PhD, Locum Cardiothoracic and Vascular Surgeon, Saudi Arabia and Middle East Hospitals
Coauthor(s): Mary C Mancini, MD, PhD, Director of Cardiothoracic Transplantation, Professor, Department of Surgery, Louisiana State University Health Sciences Center
Contributor Information and Disclosures

Updated: May 1, 2008

Outcome and Prognosis

In the present era of cardiac surgery, children with simple forms of tetralogy of Fallot (TOF) enjoy good long-term survival with an excellent quality of life. Late outcome data suggest that most survivors are in New York Heart Association classification I, although maximal exercise capability is reduced in some. Sudden death from ventricular arrhythmias has been reported in 1-5% of patients at a later stage in life, and the cause remains unknown. The surgical procedures are still palliative, and continued cardiac monitoring into adult life is necessary.

Future and Controversies

Today, some tetralogy of Fallot patients have survived for more than 15-20 years after their first operation. The major problem encountered by these individuals is the development of pulmonary valvular regurgitation. It appears that a number of these individuals require pulmonary valve replacement. Most individuals receive a pericardial homograft and only time will tell how long these valves will last.

 


More on Tetralogy of Fallot

Overview: Tetralogy of Fallot
Workup: Tetralogy of Fallot
Treatment: Tetralogy of Fallot
Follow-up: Tetralogy of Fallot
Multimedia: Tetralogy of Fallot
References
[ CLOSE WINDOW ]

References

  1. Aboulhosn J, Child JS. Management after childhood repair of tetralogy of fallot. Curr Treat Options Cardiovasc Med. Dec 2006;8(6):474-83. [Medline].

  2. Arciniegas E, Farooki ZQ, Hakimi M, Green EW. Results of two-stage surgical treatment of tetralogy of Fallot. J Thorac Cardiovasc Surg. Jun 1980;79(6):876-83. [Medline].

  3. Boechat MI, Ratib O, Williams PL, Gomes AS, Child JS, Allada V. Cardiac MR imaging and MR angiography for assessment of complex tetralogy of Fallot and pulmonary atresia. Radiographics. Nov-Dec 2005;25(6):1535-46. [Medline].

  4. Borow KM, Green LH, Castaneda AR, et al. Left ventricular function after repair of tetralogy of fallot and its relationship to age at surgery. Circulation. Jun 1980;61(6):1150-8. [Medline].

  5. Devore GR, Polanko B. Tomographic ultrasound imaging of the fetal heart: a new technique for identifying normal and abnormal cardiac anatomy. J Ultrasound Med. Dec 2005;24(12):1685-96. [Medline].

  6. Gustafson RA, Murray GF, Warden HE, et al. Early primary repair of tetralogy of Fallot. Ann Thorac Surg. Mar 1988;45(3):235-41. [Medline].

  7. Horer J, Friebe J, Schreiber C. Correction of tetralogy of Fallot and of pulmonary atresia with ventricular septal defect in adults. Ann Thorac Surg. 2005;80:2285-2291. [Medline].

  8. Kirklin JW, Blackstone EH, Kirklin JK, Pacifico AD, Aramendi J, Bargeron LM Jr. Surgical results and protocols in the spectrum of tetralogy of Fallot. Ann Surg. Sep 1983;198(3):251-65. [Medline].

  9. Lee CN, Su YN, Cheng WF, Lin MT, Wang JK, Wu MH. Association of the C677T methylenetetrahydrofolate reductase mutation with congenital heart diseases. Acta Obstet Gynecol Scand. Dec 2005;84(12):1134-40. [Medline].

  10. Lukacs L, Kassai I, Arvay A. Total correction of tetralogy of Fallot in adolescents and adults. Thorac Cardiovasc Surg. Oct 1992;40(5):261-5. [Medline].

  11. Pacifico AD, Kirklin JK, Colvin EV, et al. Transatrial-transpulmonary repair of tetralogy of Fallot. Semin Thorac Cardiovasc Surg. Jan 1990;2(1):76-82. [Medline].

  12. Pacifico AD, Ricchi A, Bargeron LM Jr, et al. Corrective repair of complete atrioventricular canal defects and major associated cardiac anomalies. Ann Thorac Surg. Dec 1988;46(6):645-51. [Medline].

  13. Patel CR, Agamanolis DP, Stewart JW. Prenatal diagnosis of tetralogy of Fallot with obstructed supracardiac totally anomalous pulmonary venous connection. Cardiol Young. Dec 2005;15(6):656-9. [Medline].

  14. Sakamoto T, Nagase Y, Hasegawa H, Shin'oka T, Tomimatsu H, Kurosawa H. One-stage intracardiac repair in combination with external stenting of the trachea and right bronchus for tetralogy of Fallot with an absent pulmonary valve and tracheobronchomalacia. J Thorac Cardiovasc Surg. Dec 2005;130(6):1717-8. [Medline].

  15. Sousa Uva M, Lacour-Gayet F, Komiya T, et al. Surgery for tetralogy of Fallot at less than six months of age. J Thorac Cardiovasc Surg. May 1994;107(5):1291-300. [Medline].

  16. Touati GD, Vouhe PR, Amodeo A, et al. Primary repair of tetralogy of Fallot in infancy. J Thorac Cardiovasc Surg. Mar 1990;99(3):396-402; discussion 402-3. [Medline].

  17. Turley K, Tucker WY, Ebert PA. The changing role of palliative procedures in the treatment of infants with congenital heart disease. J Thorac Cardiovasc Surg. Feb 1980;79(2):194-201. [Medline].

  18. Ungerleider RM. Tetralogy of fallot. In: Sabiston DC, Spencer F, eds. Surgery of the Chest. 6th ed. Philadelphia, Pa: WB Saunders Co; 1995.

  19. Redington AN. Determinants and assessment of pulmonary regurgitation in tetralogy of Fallot: practice and pitfalls. Cardiol Clin. Nov 2006;24(4):631-9, vii. [Medline].

[ CLOSE WINDOW ]

Further Reading

[ CLOSE WINDOW ]

Keywords

tetralogy of Fallot, TOF, Fallot tetrad, pink tetralogy, wooden-shoe heart, boot-shaped heart, coeur en sabot, sabot heart, congenital heart disorders, CHD, congestive heart failure, CHF, cyanosis, cyanotic heart disorder, congenital cardiac defects, ventricular septal defect, VSD, atrial septal defect, ASD, pulmonic valve atresia, pulmonic valve stenosis, infundibular stenosis, dextroposition of the aorta, right ventricular hypertrophy, pulmonary atresia, paradoxical emboli, stroke, pulmonary embolus, subacute bacterial endocarditis, right ventricle outflow tract obstruction, RVOTO, cardiopulmonary bypass, CPB, Blalock-Taussig shunt, pentad of Fallot, cleft lip, cleft palate, hypospadias, pentalogy of Fallot

[ CLOSE WINDOW ]

Contributor Information and Disclosures

Author

Shabir Bhimji, MD, PhD, Locum Cardiothoracic and Vascular Surgeon, Saudi Arabia and Middle East Hospitals
Shabir Bhimji, MD, PhD is a member of the following medical societies: American Cancer Society, American College of Chest Physicians, American Lung Association, and Texas Medical Association
Disclosure: Nothing to disclose.

Coauthor(s)

Mary C Mancini, MD, PhD, Director of Cardiothoracic Transplantation, Professor, Department of Surgery, Louisiana State University Health Sciences Center
Mary C Mancini, MD, PhD is a member of the following medical societies: American Heart Association, American Medical Association, American Thoracic Society, Association for Academic Surgery, Association for Surgical Education, International College of Surgeons, International Society for Heart and Lung Transplantation, New York Academy of Sciences, Phi Beta Kappa, and Southern Thoracic Surgical Association
Disclosure: Nothing to disclose.

Medical Editor

Gary E Sander, MD, PhD, Professor, Department of Internal Medicine, Division of Cardiology, Tulane University Health Sciences Center
Gary E Sander, MD, PhD is a member of the following medical societies: Alpha Omega Alpha, American College of Cardiology, American College of Chest Physicians, American College of Physicians, American Federation for Medical Research, American Heart Association, American Society of Hypertension, Heart Failure Society of America, Louisiana State Medical Society, and Southern Society for Clinical Investigation
Disclosure: Nothing to disclose.

Pharmacy Editor

Francisco Talavera, PharmD, PhD, Senior Pharmacy Editor, eMedicine
Disclosure: Nothing to disclose.

Managing Editor

Ronald J Oudiz, MD, Director of Pulmonary Hypertension, Associate Professor, Department of Medicine, Division of Cardiology, Harbor-UCLA Medical Center, David Geffen School of Medicine at UCLA
Ronald J Oudiz, MD is a member of the following medical societies: American College of Cardiology, American College of Physicians, and American Heart Association
Disclosure: Actelion Grant/research funds Clinical Trials + honoraria; Encysive Grant/research funds Clinical Trials + honoraria; Gilead Grant/research funds Clinical Trials + honoraria; Pfizer Grant/research funds Clinical Trials + honoraria; United Therapeutics Grant/research funds Clinical Trials + honoraria

CME Editor

Amer Suleman, MD, Consultant in Electrophysiology and Cardiovascular Medicine, Department of Internal Medicine, Division of Cardiology, Medical City Dallas Hospital
Amer Suleman, MD is a member of the following medical societies: American College of Physicians, American Heart Association, American Institute of Stress, American Society of Hypertension, Federation of American Societies for Experimental Biology, Royal Society of Medicine, and Society of Cardiac Angiography and Interventions
Disclosure: Nothing to disclose.

Chief Editor

Park W Willis IV, MD, Sarah Graham Distinguished Professor of Medicine and Pediatrics, University of North Carolina at Chapel Hill School of Medicine
Park W Willis IV, MD is a member of the following medical societies: American Society of Echocardiography
Disclosure: Nothing to disclose.

 
 
HONcode

We subscribe to the
HONcode principles of the
Health On the Net Foundation

All material on this website is protected by copyright, Copyright© 1994- by Medscape.
This website also contains material copyrighted by 3rd parties.

DISCLAIMER: The content of this Website is not influenced by sponsors. The site is designed primarily for use by qualified physicians and other medical professionals. The information contained herein should NOT be used as a substitute for the advice of an appropriately qualified and licensed physician or other health care provider. The information provided here is for educational and informational purposes only. In no way should it be considered as offering medical advice. Please check with a physician if you suspect you are ill.