Repaired Tetralogy of Fallot

Abstract

While a substantial minority of patients with repaired tetralogy of Fallot (rTOF) have normal exercise performance, as a group their performance is mild-moderately decreased, and there is a cohort with markedly decreased exercise capacity. The factors responsible for the rTOF patient’s exercise intolerance are probably diverse and may vary from patient to patient. In most cases, residual cardiovascular lesions (pulmonary stenosis, pulmonary regurgitation, and especially right ventricular dysfunction) are the most important issues. The dynamic interplay between these variables and their effect on exercise function is complex, however, and can vary over time. The combination of an incompetent pulmonary valve and residual pulmonary artery stenoses is particularly deleterious and results in interesting physiology that is uniquely appreciated in the exercise physiology laboratory. Exercise testing can be safely performed in a wide range of TOF patients. Data from exercise testing in rTOF patients has important prognostic and clinical implications.