Outlook

After successful surgery, children generally don't have any symptoms and lead normal lives with few, if any, restrictions. However, the surgery itself may have some long-term complications. These include the following:

• Right ventricular failure: Right ventricular failure is possible, especially if surgery created severe pulmonary valve insufficiency, that is regurgitation of blood backwards from the pulmonary artery into the right ventricle.  
  
  
• Electrical conduction abnormalities: Every patient with tetralogy of Fallot has right bundle branch block secondary to the congenital ventricular septal defect. But sewing the patch into the ventricular septum can create heart block or failure of the upper atria to conduct/communicate with the lower ventricles. A permanent pacemaker is occasionally needed.
  
  
• Arrhythmias: Because of surgery on the ventricles, postoperative ventricular tachycardia (VT) is an infrequent risk. This is a life-threatening arrhythmia, so follow-up detection of risk for ventricular tachycardia is important. 
  
  
• Residual hole in the ventricular septum: This is also possible, with oxygenated blood passing from the left side of the heart to the right (shunting).