Surgical repair of tetralogy of Fallot in adults today.

BACKGROUND: Today, corrective surgery of native tetralogy of Fallot beyond childhood is a rare exception. In the years following the fall of the Berlin wall, 22 adults with uncorrected tetralogy presented to our center, mostly from former Eastern Block countries. HYPOTHESIS: Our aim was to examine whether adults with tetralogy of Fallot benefit from late surgical repair. Nineteen patients underwent corrective surgery; hospital mortality was 16%. Follow-up examination 3.5 (0.3-9.7) years postoperatively consisted of chart review and a written questionnaire. Incidence of ventricular arrhythmias was 32% before surgery and increased to 50% 3.5 years after surgery. Clinical status and New York Heart Association classification were clearly improved. This was not reflected in an improvement of the patients' socioeconomic status, as none of the 9 patients in our group of 19, who were jobless before the surgery, experienced a change in employment status. Marital status did not change in any patient and, in particular, the number of single male patients remains high. Except for one nearly asymptomatic younger woman who had delivered four children, only one of the seven married women had delivered a child before and one of the younger women after cardiac repair, which we consider to be a positive effect of this surgery. Surgical correction of adult patients with tetralogy of Fallot carries a higher risk compared with correction in childhood. It improves quality of life but does not change socioeconomic habits.