Results of corrective surgery for tetralogy of Fallot.

During a 5-year period (1978-1983) corrective surgery for tetralogy of Fallot was performed in 114 patients, ranging in age from 2 to 24 years (mean 8.4 years). Forty-one of them (35.9%) had previously undergone a palliative operation. Insertion of a transannular patch was necessary in 48 patients (42.1%). Eleven children died in the immediate postoperative period (early mortality 9.6%); no deaths occurred later. 103 survivors were followed-up for periods ranging from 5 months to 5 years mean 2.4 years) after surgery. The condition in 91 patients was excellent (88.7%), in 11 good (10.7%) and in one poor. Residual ventricular septal defect persisted in 9 patients (8.7%). Postoperative ECG revealed complete right bundle branch block in 71 patients (59%), incomplete block in 18 (18%), 5 patients (5%) had complete RBBB with left anterior hemiblock. Postoperative dysrhythmia requiring treatment was found in 7 patients (6%). Of 82 patients thoroughly examined by echocardiography, 37 (45%) had pulmonary regurgitation, 29 (35%) pulmonary plus tricuspid regurgitation, and 3 (4%) isolated tricuspid regurgitation. 83% of the patients had impaired lung function.