[Long-term follow-up of tetralogy of Fallot corrected by Okamura's method under simple deep hypothermia]

Corrective surgeries for TOF (Tetralogy of Fallot) were performed in 350 patients from 1967 to 1983 by Okamura's method under simple deep hypothermia. Radical operations were done in all patients, including very young children. The operative techniques had several differences from the standard procedure. Patients were operated on without any extracorporeal perfusion, the VSD was closed by a patch which was attached firmly to the margin of VSD using cross mattress sutures and the right ventricular outflow tract was dilated by infundibular myectomy only, with no use of outflow-patch-plasty. One hundred ten out of 350 patients were investigated by questionnaire and their responses showed that they had few long-term problems. ECG, X-ray, echocardiography and stress test by treadmill were performed in 26 cases. They were divided into two groups by the presence or absence of pulmonary regurgitation (PR). The CTR of the PR (+) group was larger than the PR (-) group (p less than 0.05). There was no statistical difference in cardiac function between the two groups. Few arrhythmias were observed during the exercise test. No residual shunts were found in any of the cases. The occurrence of PR was relatively rare in those who were operated on before their second birthdays. These results suggest that our surgical techniques under simple deep hypothermia are adequate to correct TOF.