A case report of Tetralogy of Fallot in the adult with severe congestive heart failure

We operated on a 47-year-old male for Tetralogy of Fallot with severe right heart dysfunction (RVEF 25%, RVEDP 15 mmHg, massive TR) and right heart failure (ascites and edema). The operation was completed successfully. However, persistent severe arrhythmia occurred in the CCU and assisted circulation was used for 6 days until the patient's condition stabilized. Arrhythmia diminished and hemodynamic status improved gradually. The patient improved sufficiently to be able to eat and read books. Unfortunately, he died of sudden ventricular arrhythmia on 69 POD. It was suspected that the right ventricle in this case had deteriorated beyond the threshold for surviving the radical operation for Tetralogy of Fallot.