[Tetralogy of Fallot. 20 years' experience in 144 cases]

Abstract

Between 1968 and December 1987, 144 patients with tetralogy of Fallot were examined at La Pitié Hospital, Paris. 76 were female and 68 male, with a mean age of 8.1 years at the first visit. The patients were regularly followed up by the same physician relying on radiography of the chest, electrocardiography and, since 1982, two-dimensional echocardiography. These visits were coupled with an interview with the welfare officer attached to our department for information on the patient's way of life as well as his socio-professional and familial problems. 129 patients of mean age 14.8 years underwent corrective surgery preceded in 81 cases by palliative surgery. The overall immediate mortality rate was 12.4% (16 cases), falling from 19.5% between 1968 and 1977 to 3% during the last 10 years. The mean follow-up period was 10.7 years, with 51 patients being followed up for more than 10 years and 18 for more than 20 years. Late mortality now stands at 5.3% (7 patients, 6 of whom died of a cardiac cause). Residual lesions consisted in significant (27%) pulmonary insufficiency in 35 patients, residual interventricular septal defect in 16 patients (12.4%) and pulmonary obstruction in 11 patients (8%). 18 patients presented with dysrhythmias, including 7 cases of ventricular arrhythmia; 5 two-bundle blocks and 5 complete atrioventricular blocks were also observed. 11 patients required reoperation with a 27.2% mortality rate (3 cases).(ABSTRACT TRUNCATED AT 250 WORDS)