The long-term influence of pulmonary valve regurgitation following repair of tetralogy of Fallot: does preservation of the pulmonary valve ring affect quality of life?

The transannular patch (TAP) repair used in the correction of tetralogy of Fallot (TOF) inevitably causes pulmonary regurgitation. We report herein the results of a long-term follow-up study conducted on 50 patients who had undergone a TAP repair 20-29 years earlier to evaluate the influence of pulmonary regurgitation on their late outcome and quality of life. As a control, 26 patients with an intact pulmonary valve ring and right ventricular outflow patch (RVP) confined to the subvalvular region were also studied. The 25-year survival rates of the TAP and RVP groups were 88.5% and 95.7%, respectively, and the event-free rates at 25 years were 73.3% and 90.9%, respectively. Although the absolute values of these rates were higher in the RVP group, there were no statistically significant differences between the two groups. To assess quality of life, the occupational status, childbearing ability, and late symptoms were evaluated, and found to be comparable between the two groups. Moreover, a treadmill submaximal stress test did not show any differences in exercise capacity between the two groups. In conclusion, the presence of a TAP does not significantly alter the late results or quality of life of patients who have undergone repair of TOF.