Key result
Surgical repair of tetralogy of Fallot provides excellent outcomes, but patients require lifelong follow-up due to the risk of arrhythmias, chronic pulmonary regurgitation, and ventricular dysfunction.
Adults with repaired tetralogy of Fallot require lifelong follow-up to monitor for right ventricular dysfunction, arrhythmias, and to determine the optimal timing for pulmonary valve replacement.
Supports lifelong surveillance after tetralogy of Fallot repair; leaves open optimal pulmonary valve replacement timing.
Tetralogy of Fallot is a common complex congenital heart disease, nowadays amenable to safe surgical repair with good early and long-term outcomes. Notwithstanding this, surgical repair is not a definite treatment, and the heart of patients with tetralogy of Fallot remains anatomically, physiologically and electrically abnormal. Indeed, long-term survival of patients with repaired tetralogy of Fallot differs from that of the general population. Major long-term complications include supraventricular and ventricular arrhythmias, with risk of sudden cardiac death, and chronic pulmonary regurgitation, which gradually leads to right ventricular dilation and dysfunction. Thus, the primary aims of clinical follow-up for adult patients with repaired tetralogy of Fallot should be to assess ventricular morphology and function, to stratify the arrhythmic risk and to define the optimal surgical or interventional timing.
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Padalino et al. (2014) conducted a review in Tetralogy of Fallot. Surgical repair and long-term follow-up was evaluated. Surgical repair of tetralogy of Fallot provides excellent outcomes, but patients require lifelong follow-up due to the risk of arrhythmias, chronic pulmonary regurgitation, and ventricular dysfunction.
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