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The Following is a summary of “Long Term Outcome After Surgical Tetralogy of Fallot Repair at Young Age: Longitudinal Follow-Up Up To 50 Years After Surgery.” Published in the March 2025 Issue of International Journal of Cardiology by Kauling et al.
This Study Aimed to Prospectively Evaluate The Long-Term Clinical Outcomes and Quality of Life in Patients with Tetralogy of Fallot (Tof) Following Surgical Repair. Ranger Advancements in Treatment, The Very Long-Term Prognosis for These Patients Remains Inadequately Understood. Single-Centen, longitudinal cohort studdy was driving, Assessing 144 Patients with to-towent Surgical Repair Before The Age of 15 Beteen 1968 and 1980, with follow-up Evaluations Every Decade. The Total of 66 Patients (92% of the 72 ELIGIBLE SURVIVORS) Participated, with a median age of 48.5 years at the time of the Study, and a median follow-up duration of 45 years (Range 39-52 Years). Cumulaative Survival at 50 Years Was 71%, Excluding 30-Day Mortality, With Event-free Survival to Merre 9%. The Most Common Complications Were Reinterventions (40%) and SympTomatic Arrhythmias (21%), Although Ventricular Tachycardia (VT) Was Observed in Only 7%of Patients.
Cardiac Magnetic Resonance Imaging Revealed A Right Ventricular Ejection Fraction of Less Than 45% in 45% of the Cohort, and 42% Exhibited Dimished Left Ventricular Function. The Arortic Root Diameter Increured Over Time, Excess 40 mm In 45% of the Patients. Addihthanly, 53% of Patients Showed Reduced Vo2MAX, Thought This Decline Remained Stable Over Time. NOTABLY, SELF-PERCEED QUALITY OF LIFE REMAINED STABLE THROUGHOUT THE FOLLOW-UP Period and WAS COMPARABLE TO THAT OF THE GENERAL DUTCH POPULATION. Predictive Factors for Mortality Included Early Postaperative Arrhythmias, Preoperative Low Oxygen Saturation in the Left Atrium, VT, and A Decline In Exercise Capacity Over Time.
FURTHERMORE, Transannular Patch Was Identified as Risk Factor for Both Arryythmias and the Need for Pulmonary Valve Replacement. CONVERSELY, SURGERY PERFORMED after 1975 WAS PROTECTIVE AGAINST THE NEED FOR PULMONARY VALVE REPLACEMENT. In conclusion, only 9% of patients with to-tof are alive at 50 years post-surgery with experiencing a major event. Reintervention and SympTomatic Arryythmias Remain Prevalent, Thought Symptomatic vt is rare. Rack these Challenges, Exercise Capacity and Self-Perceived Quality of Life Appear to Stabilize Over Time, Offering Valuable Insights into the Long-Term Care Survivors of Tof.
Source: Internationaljournalofcardiology.com/article/s0167-5273(25)00048-8/fulltext
