Tetralogy of Fallot Surgery-30 years experience from a single institution

  • Prof Harald Lindberg, Rikshospitalet, University of Oslo, Norway
  • Dr Sigurd Birkeland, Rikshospitalet, University of Oslo, Norway
  • Dr Kjell Saatvedt, Rikshospitalet, University of Oslo, Norway
  • Dr Tom Hoel, Rikshospitalet, University of Oslo, Norway
  • Dr Egil Seem

    • AIM OF STUDY: To evaluate all patients with a diagnosis of Tetralogy of Fallot (TOF) and related congenital malformations (Double Outlet Right Ventricle of TOF type, Pulmonary Atresia of TOF type, TOF with absent Pulmonary Valve, TOF with AV-canal) surgically treated in our Department during the period 1979 through 2007.

    METHODS: Patient records and the database of the department were evaluated, including earlier procedures performed in all patients. The official death registry of Norway was used for follow up

    RESULTS: A total of 420 patients were included in the study. There were 22 early and 23 late deaths.
    399 patients have had a reparative procedure performed, with an EM of 11 (2,75 %). 151 cases has undergone a second repair, 47 have had a third operation performed, ten patients have been operated for a 4th time. Only three patients have been operated on with sternotomy for the 5th time. Mortality in this group was 15 early and 14 late.Our current policy is to do a primary repair at any age if the pulmonary valve is of adequate size.

    CONCLUSION: Surgical treatment of the Tetralogy of Fallot and related congenital cardiac malformations has been performed for a long time with good results in our Department. In this cohort of patients almost 40% required additional procedures later on, in some cases as many as four additional surgeries. Reoperations carries a low risk in the second and third procedure, but may be more hazardous doing sternotomy for the fourth or fifth time.