Key result
Among 4,010 adult patients with repaired Tetralogy of Fallot in Japan, 5.9% underwent reoperation, most commonly for pulmonary stenosis, and 1.1% experienced sudden cardiac death.
Cross-Sectional (n=4,010)
Yes
In Japan, pulmonary stenosis is the leading indication for reoperation in adult repaired Tetralogy of Fallot patients, but specific criteria vary widely among institutions, highlighting the need for standardized guidelines.
Variable reoperation criteria in repaired TOF may persist; leaves open standardized guidelines and prospective outcome validation.
BACKGROUND: Although the survival rate for repaired Tetralogy of Fallot (TOF) is dramatically improving, anatomical and functional residua and sequelae followed by arrhythmias and sudden death are still challenging issues to be resolved. Reoperation can reduce the incidence of arrhythmias and sudden death, but there is no consensus on the indications of reoperation for patients with TOF, especially in Japan. METHODS AND RESULTS: A cross-sectional questionnaire survey of reoperation indications in patients with TOF was performed through a Japanese multicenter study. The questionnaire, which focused on the number of repaired TOF patients aged >15 years old, reoperation indications and management, was sent to the institutions belonging to Japanese Society for Adult Congenital Heart Disease. In total, 41.5% (78/188) of the institutions replied. The total number of repaired TOF patients was 4,010, and sudden cardiac death was observed in 45.236/4,010 (5.9%) experienced reoperation. Pulmonary stenosis (32%) and pulmonary regurgitation (29%) were the most common reasons for reoperation. There were only 2 implantable cardioverter defibrillator or resynchronization therapy defibrillator implantations. The physiological/anatomical indications of reoperation differed among the hospitals. CONCLUSIONS: Approximately 1.1% of patients suffered sudden death and 6% of repaired TOF patients had reoperation. The indications of reoperation, however, varied among the institutions. Therefore, detailed information for each case of sudden death or reoperation should be collected and analyzed in order to establish guidelines for reoperation.
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Mizuno et al. (2013) conducted a cross-sectional in Tetralogy of Fallot (n=4,010). Repaired Tetralogy of Fallot was evaluated on Reoperation rate. Among 4,010 adult patients with repaired Tetralogy of Fallot in Japan, 5.9% underwent reoperation, most commonly for pulmonary stenosis, and 1.1% experienced sudden cardiac death.
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