[Long-term evaluation, physical and sports activities after correction of Fallot's tetralogy]

The aim of this study was to assess the result of surgical repair of Fallot's tetralogy (FT) and to advise physical and sporting activities. Thirty-two patients (20 boys and 12 girls) underwent correction of FT either before 4 years of age (14 cases) or after (18 cases). The patients were assessed on average 7.5 years postoperatively (range 4 to 13 years). All but one were class I of the NYHA classification. Radiological cardiomegaly was observed in 3 cases (CTI greater than 0.55). Sinus rhythm was present in all cases: 27 out of 30 had complete right bundle branch block without bifascicular block. Holter monitoring was performed in 22 cases: occasional monomorphic VES (1 to 15/hour) were observed in 7 cases. Frequent polymorphic VES were observed during exercise in one adult. Echocardiography and cardiac catheterization revealed pulmonary regurgitation and right ventricular dilatation in over half the cases, with an infundibular aneurysm in 2 cases and a residual pressure gradient of 55 and 66 mmHg in 2 other cases requiring reoperation. Left ventricular function was satisfactory in all cases. Treadmill exercise testing was performed in 28 patients. However, for statistical analysis 12 boys aged 7 to 15 years were compared with 11 controls of the same age. There was a significant decrease in maximal O2 consumption, of CO2 excretion, of ventilation, of heart rate, of work developed and total work in the operated patients. Clinical assessment and complementary investigations are essential 5 to 10 years after correction of FT to detect latent abnormalities and to better advise patients on physical and sporting activities.