669 Long-Term Outcome of Adult Survivors of Tetralogy of Fallot
Section snippets
Background
Cohort studies of tetralogy of Fallot (TOF) often include a high proportion of right ventriculotomy repairs.
Objectives
To examine the contemporary long-term outcome after TOF repair.
Methods
Single centre retrospective study of 293 patients aged ≥16 years with previous TOF repair. Repair was performed at a median age of 2.6 years (IQR 1.1-5.1 years) using a trans-atrial/trans-pulmonary approach in 51% (149/293) and right ventriculotomy in 34% (101/293) (unknown 15%).
Results
After a median adult centre follow-up of 9 years (IQR 3.9-15.5 years), there was excellent survival (n=284, 97%). Age adjusted survival was 99%, 95%, and 83% at 20, 40, and 60 years of age, respectively. Just over half required ≥1 pulmonary valve replacement (PVR) (164, 56%) at a median age of 31 years (IQR: 20-39 years). Arrhythmia endpoints occurred in 24% (70/293), being atrial fibrillation/flutter in 12% (36/293) and ventricular tachycardia in 5.5% (16/293). Freedom from PVR and arrhythmia
Conclusions
Long-term adult survival after TOF repair with a trans-atrial/trans-pulmonary approach is excellent. A significant proportion of patients require a PVR or experience an arrhythmia by the sixth decade of life.