Conte M R, Presbitero P, Aruta E, Montemurro D, Villani M, Brusca A
Cardiologia. 1989 Mar;34(3):265-9.
Patients may die suddenly after surgical repair of tetralogy of Fallot. Ventricular arrhythmias (VA) have been considered the possible cause of sudden death in such patients by many Authors. We evaluated the incidence and severity of VA in a group of 65 patients (25 females and 40 males) after surgical repair of tetralogy of Fallot. The age at the time of follow-up varied between 8 and 47 years. We divided our population into 4 groups (A, B, C, D) according to the surgical results (poor and good) and to the age of total correction (less than 12, greater than 12 years). We tested the presence and severity of VA in the different groups of patients and we found a significant difference in the incidence of VA between patients who underwent surgery before and after the age of 12 years (p = 0.0083). The surgical result did not show a significant relation with VA (p = 0.47). Among the patients submitted to surgical repair in the adult age, however, more serious VA are present in those with poor surgical result, and both our cases of sudden death occurred in this kind of patient. We speculate that postoperative ventricular arrhythmias are related to right ventricular function, which in turn appears to be worse in patients who underwent surgical correction at a later age. At last only perspective trials will be able to assess the significance of VA and their relationship with sudden death in this kind of patient.
法洛四联症手术修复后患者可能会突然死亡。许多作者认为室性心律失常（VA）可能是这类患者猝死的原因。我们评估了65例（25例女性和40例男性）法洛四联症手术修复后患者的室性心律失常的发生率和严重程度。随访时年龄在8至47岁之间。我们根据手术结果（差和好）以及完全矫正的年龄（小于12岁、大于12岁）将我们的人群分为4组（A、B、C、D）。我们检测了不同患者组中室性心律失常的存在情况和严重程度，发现12岁之前和之后接受手术的患者之间室性心律失常的发生率有显著差异（p = 0.0083）。手术结果与室性心律失常没有显著关系（p = 0.47）。然而，在成年期接受手术修复的患者中，手术结果差的患者存在更严重的室性心律失常，并且我们的两例猝死病例都发生在这类患者中。我们推测术后室性心律失常与右心室功能有关，而右心室功能在较晚年龄接受手术矫正的患者中似乎更差。最后，只有前瞻性试验才能评估这类患者中室性心律失常的意义及其与猝死的关系。
