A Clinical Study of Tetralogy of Fallot

The clinicolaboratory findings, cardiac catheterization, and outcome of operation were analyzed in 78 patients with tetralogy of Fallot, which were diagnosed by echocardiography, cardiac catheterization, and a cardiac angiography and confirmed by operation at Dong San Hospital, Keimyung University, during a 4½-year period from January 1984 to June 1988.

The following results were obtained :

1) Out of the 78 cases, 45 were male and 64 were female.

2) The electrocardiogram showed right axis deviation in 71 cases(91%) and right ventricular hypertrophy in 66 cases(84.6%).

3) Chest X-ray revealed that, the cardiothoracic ratio was normal or decreased in 68 cases(87.3%), and cardiac apex elevation was noticed in 57 cases(73%).

4) Pulmonary stenosis were chiefly valvular and infundibular type(53.8%).

5) The associated heart diseases with TOF were patent foramen ovale(64.1%), right sided aortic arch(19.2%), and secundum ASD(10.3%), in that order.

6) There was an intimate correlation between secondary polycythemia and thrombocytopenia.

7) Among the 78 Cases, 73 cases had total correction, 1 case had shunt operation, and 4cases had total correction after shunt operation. The highest mortality rate occurred in the cases of total correction after shunt operation(25%). The cases with a main pulmonary artery size of 1/3 to 2/3 against, the aorta had a higher mortality than the other group, and no cases expired in the group with a ratio of more than 2/3. The overall surgical mortality was 8.9%.