Tetralogy of Fallot (TOF) is the most common form of cyanotic congenital heart disease. The aim of this study was to examine the exercise performance of young patients following the repair of TOF and to assess the influence of different variables related to the surgical repair on exercise testing. This study was conducted on 21 patients (16 males and 5 females) operated on for TOF compared to 15 healthy age- and sex-matched control children. The patients' median age at time of the study was 8 years (range 5–13 years) while age at surgical repair was 5 ± 2.1 years (range 2–10 years). Patients were subjected to 2D and color Doppler echocardiographic examination. Treadmill exercise stress testing was performed for all subjects according to modified Bruce protocol. The resting ECGs of all patients revealed normal sinus rhythm and RBBB. Cases had lower exercise capacity when compared to control subjects and those with aortopulmonary shunt showed significantly lower exercise performance when compared to those without aortopulmonary shunt. In conclusions, exercise tolerance after total correction of TOF is slightly impaired on short-term followup with more affection among patients with previous aortopulmonary shunts. The present study did not reveal any serious ventricular arrhythmia. 1. Introduction Tetralogy of Fallot (TOF) is the most common form of cyanotic congenital heart disease. Impairment in exercise tolerance after total repair of tetralogy of Fallot has been frequently reported and speculated to be due to variable causes including residual right ventricular outflow tract (RVOT) obstruction, branch pulmonary artery stenosis, pulmonary insufficiency, pulmonary pathology, and chronotropic incompetence [1]. Pulmonary regurgitation (PR) has been shown to be related to the use of transannular patch during RVOT reconstruction and aggressive infundibulectomy involving the pulmonary valve annulus. Adverse effects of PR include progressive dilatation of RV, reduced exercise capacity, arrhythmia, and sudden death [2]. A number of children have premature ventricular beats after repair of the tetralogy of Fallot. These beats are of concern in patients with residual hemodynamic abnormalities; 24-hr electrocardiographic (Holter) monitoring studies should be performed to be certain that occult short episodes of ventricular tachycardia are not occurring. Exercise studies may be useful in provoking cardiac arrhythmias that are not apparent at rest [3]. The aim of this study was to assess the exercise performance of young patients following the repair of Tetralogy of
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