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.