Twenty-nine cyanotic patients with tetralogy of Fallot ranging in age from 16 to 43 years (mean, 21 yrs) have undergone total correction. Only two (6.8%) patients had previous Blalock-Taussig shunt. The established intracardiac technique for total repair was used throughout. In four (13.75) patients, reconstruction of the pulmonary outflow tract was required. The hospital mortality was 13.7% (4 of 29 patients). All deaths occurred in the beginning of the experience (1967-1977), when disposable oxygenators and myocardial protection were not used. The follow-up for the surviving patients was 1560 patient-months (mean, 62 months). There was one late death, not cardiac related. All but two survivors had good clinical results. These two patients were successfully reoperated for correction of residual defects at six months and 11 years after the initial procedure, respectively. We believe that advanced age is not a contraindication for total repair of tetralogy of Fallot since patients with this anomaly surviving to adulthood usually show favourable morphology.
tetralogy of Fallot