J.Jpn. Surg. Soc.. 99(2): 73-77, 1998

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Feature topic

REOPERATION AFTER CORRECTIVE SURGERY FOR TETRALOGY OF FALLOT

Thirty-six patients (7.6％) underwent reoperation after total correction of tetralogy of Fallot in our institution from 1955 to 1997. Eight patients underwent a second reoperation in the same follow-up period. The indications for surgical repair were recurrent or residual lesions alone (Qp/Qs≧2.0, right ventricule-pulmonary artery pressure gradient≧50 mmHg, tricuspid regurgitation : (TR) ≧grade 3, pulmonary regurgitation (PR) ≧grade 3), or in combination with other lesions. The reoperation consisted of closure of a residual VSD in 12 patients (33.3％), relief of right ventricular outflow obstruction in 12 (33.3％), tricuspid valve repair or replacement for TR in 11 (30.6％), and pulmonary valve repair or replacement for PR in 10 (27.8％). The indications for second reoperation consisted of mainly residual or recurrent TR or infectious endocarditis. There was one operative death (2.8％) in the reoperation group and one death (12.5％) in the second reoperation group. Five patients (14.7％) died during a follow-up period of 1-25 years (mean 11.6 years). Twenty-nine patients (80.6％) suvived surgery, and 25 (86.2％) are now in NYHA class I and 4 in class II. Reoperation and second reoperation are associated with a low mortality rate and good long-term results in our surgical experience.

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