Tetralogy of Fallot: A Philippine Heart Center Review

Abstract

INTRODUCTION: Tetralogy of Fallot (TOF) is the most common cyanotic congenital heart disease (CHD) in the adult. The Philippine Heart Center (PHC) performs surgery on most TOF patients, averaging 50 patients per year. This study aimed to provide a comprehensive review of literature regarding TOF post operative outcomes in the Philippines. METHOD: Studies conducted at PHC that included 20 or more patients were included and reviewed independently by two investigators for validity. RESULTS: Five published and 22 unpublished studies were retrieved, with 12 studies meeting the inclusion criteria and validity standards. The mean mortality rate with TOF correction at the PHC from 1975 to 2011 was 6.7%. From 2000-2011, the mortality rate was 5.50%. Complications included myocardial failure, arrhythmias, infective endocarditis, and growth retardation. Electrocardiography and two dimensional echocardiography were indispensable tools in the follow-up of TOF patients post correction. Most patients had New York Heart Association Functional Class I, and had normal exercise tolerance, intelligence, and fertility. CONCLUSION: Although surgical outcome has been good in the Philippines, there should be emphasis on earlier intervention to avoid complications. With the growing number of TOF patients who survive into adulthood, it is important to have consistent follow-up with an expert cardiologist keen on CHD.