The Journal of Thoracic and Cardiovascular Surgery, Vol 70, 529-535, Copyright © 1975 by The American Association for Thoracic Surgery and The Western Thoracic Surgical Association
Intracardiac repair of tetralogy of Fallot. Five-year review of 403 patients
L Chiariello, J Meyer, DC Wukasch, GL Hallman and DA Cooley
During the 5 year period 1969 to 1973, 403 patients underwent intracardiac
repair of tetralogy of Fallot. The patients ranged in age from 3 months to
41 years. Before operation, 86 per cent were cyanotic and 14 per cent were
acyanotic. Forty-nine per cent had had at least one palliative procedure
before total correction. Mahor associated anomalies included atrial septal
defect in 24 per cent, patent ductus arteriosus in 2.5 per cent, coronary
anomalies in 4 per cent, and left superior vena cava in 4.5 per cent. Seven
per cent of the patients had pulmonary atresia. Pulmonary valvotomy was
performed in 111 patients and complete excision of the pulmonary valve in
151. Patch graft reconstruction of the right ventricular outflow tract was
performed in 57 per cent of the patients. In 11 patients a conduit was used
to connect the right ventricle to the pulmonary artery. The over-all
hospital mortality rate was 9.5 per cent, with the lowest rate (3.5 per
cent) in the age group 6 to 10 years and the highest in the infant and
adult groups (16.5 and 14.5 per cent, respectively). Three known late
deaths occurred. A residual ventricular septal defect (VSD) was found in 3
per cent of the patients and an aneurysm of the pericardial patch in the
right ventricular outflow tract developed in 7 patients. Intracardiac
repair of the tetralogy of Fallot can be performed with reasonable risk and
low morbidity. In our experience the optimal age for elective surgery is
between 6 and 10 years.
