What is the life expectancy of a person with Tetralogy of Fallot (TOF)?

From the Guidelines

The life expectancy for individuals with Tetralogy of Fallot (TOF) who receive modern treatment is generally good, with many patients living well into adulthood, and with a 35-year survival rate of approximately 85% 1. With early surgical repair, typically performed in infancy, most people with this condition can expect to live into their 60s or 70s. However, this is an average, and individual outcomes can vary based on the severity of the defect, the success of surgical interventions, and ongoing medical management. Patients with tetralogy of Fallot require lifelong cardiac care, including regular check-ups with a cardiologist, echocardiograms, and potentially additional procedures as they age. Some may need pulmonary valve replacement later in life. Adhering to medical advice, maintaining a heart-healthy lifestyle, and promptly addressing any complications are crucial for maximizing life expectancy. It's essential to note that life expectancy has dramatically improved over the past few decades due to advancements in surgical techniques and post-operative care. While tetralogy of Fallot remains a serious condition, many patients now lead full, active lives with appropriate medical management. Key factors that influence life expectancy in TOF patients include:

• Severity of the defect
• Success of surgical interventions
• Ongoing medical management
• Presence of residual lesions or complications, such as pulmonary regurgitation or ventricular dysfunction
• Need for reintervention, such as pulmonary valve replacement According to the most recent guidelines, patients with TOF should be managed with a comprehensive approach, including regular monitoring, medical therapy, and potentially surgical or catheter-based interventions to address residual lesions or complications 1.

From the Research

Life Expectancy of Tetralogy of Fallot (TOF) Patients

• The life expectancy of TOF patients has been studied in several research papers, with varying results depending on the study population and follow-up period.
• A study published in 2014 2 found that the cumulative survival rate of TOF patients 40 years after surgical correction was 72%.
• Another study published in 1997 3 reported actuarial 10-, 20-, 30-, and 36-year survival rates of 97%, 94%, 89%, and 85%, respectively, after surgical repair of TOF.
• A study of adult patients who underwent TOF repair at the age of 18 or older found that actuarial 10,20,30, and 35-year survival rates were 94%, 93%, 83%, and 72%, respectively, which is not different from normal life expectancy 4.
• These studies suggest that TOF patients can have a relatively normal life expectancy, especially if they undergo surgical repair at a young age and do not experience complications such as pulmonary valve regurgitation.

Factors Affecting Life Expectancy

• Several factors have been identified as predictors of late mortality in TOF patients, including:
  • Previous shunt operation 2
  • Low temperature during surgery 2
  • Early postoperative arrhythmias 2
  • Date of operation (before 1970) 3
  • Preoperative polycythemia 3
  • Use of a right ventricular outflow patch 3
• These factors can increase the risk of late mortality and should be taken into account when managing TOF patients.

Quality of Life and Functional Status

• Studies have also examined the quality of life and functional status of TOF patients after surgical repair.
• A cross-sectional study published in 2014 5 found that TOF patients who had not required subsequent pulmonary valve replacement had good exercise capacity and quality of life, similar to healthy norms.
• Another study published in 2019 6 discussed the importance of managing pulmonary valve regurgitation in TOF patients, which can affect exercise tolerance and right ventricular function.