{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T04:13:27Z","timestamp":1792556007904,"version":"4.5.0"},"reference-count":24,"publisher":"BMJ","issue":"1","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Open Heart"],"accepted":{"date-parts":[[2016,12,22]]},"published-print":{"date-parts":[[2017,3]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Survival of patients with repaired tetralogy of Fallot (rToF) into young adulthood is very good. Concerns exist, however, over long-term morbidity and mortality as these subjects reach middle age. We aimed to assess survival and the prevalence of complications in patients with rToF seen in our Adult Congenital Heart Disease (ACHD) service.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>One hundred and sixty-eight consecutive patients with \u2018simple rToF\u2019, aged over 16 years, followed up at our tertiary-level ACHD service in Sydney, Australia since 2000, were included. We documented mortality and analysed the prospectively defined composite end points of (a) \u2018Serious adverse events\u2019, including death, heart failure hospitalisation and\/or documented ventricular arrhythmia and (b) \u2018Adverse events\u2019 inclusive of the above and endocarditis, atrial arrhythmia, defibrillator and\/or pacemaker implantation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Mean age at the last follow-up was 34\u00b112 years, and 55% were men. There were 10 (6%) deaths, and 26 patients (16%) experienced a \u2018serious adverse event\u2019. Fifty-one patients (30%) experienced an \u2018adverse event\u2019 and 29 patients had atrial arrhythmias. One hundred and one (61%) patients had at least one pulmonary valve replacement. By age 40 years, 93% were free of serious adverse events, and 83% were free of any adverse event. By age 50 years, only 56% had not had an adverse event. Older age and history of atrial arrhythmia were predictive of serious adverse events.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Survival into mid-adulthood in patients with rToF is very good; however, a substantial number of survivors have adverse events by the age of 50 years.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/openhrt-2016-000564","type":"journal-article","created":{"date-parts":[[2017,3,1]],"date-time":"2017-03-01T20:10:26Z","timestamp":1488399026000},"page":"e000564","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":70,"title":["Adults with repaired tetralogy: low mortality but high morbidity up to middle age"],"prefix":"10.1136","volume":"4","author":[{"given":"Mark","family":"Dennis","sequence":"first","affiliation":[{"name":"Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia"},{"name":"Department of Cardiology, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ben","family":"Moore","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Irina","family":"Kotchetkova","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lynne","family":"Pressley","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rachael","family":"Cordina","sequence":"additional","affiliation":[{"name":"Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia"},{"name":"Department of Cardiology, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David S","family":"Celermajer","sequence":"additional","affiliation":[{"name":"Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia"},{"name":"Department of Cardiology, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2017,3,1]]},"reference":[{"key":"2025081710221814000_4.1.e000564.1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCOUTCOMES.111.963603"},{"key":"2025081710221814000_4.1.e000564.2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.114.009454"},{"key":"2025081710221814000_4.1.e000564.3","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(00)02714-8"},{"key":"2025081710221814000_4.1.e000564.4","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejcts.2008.06.050"},{"key":"2025081710221814000_4.1.e000564.5","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199308263290901"},{"key":"2025081710221814000_4.1.e000564.6","doi-asserted-by":"publisher","DOI":"10.1055\/s-2007-1013719"},{"key":"2025081710221814000_4.1.e000564.7","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(09)60657-7"},{"key":"2025081710221814000_4.1.e000564.8","doi-asserted-by":"publisher","DOI":"10.1136\/heartjnl-2012-302147"},{"key":"2025081710221814000_4.1.e000564.9","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0000000000000204"},{"key":"2025081710221814000_4.1.e000564.10","doi-asserted-by":"publisher","DOI":"10.1136\/heartjnl-2013-304958"},{"key":"2025081710221814000_4.1.e000564.11","doi-asserted-by":"publisher","DOI":"10.1136\/hrt.2006.104745"},{"key":"2025081710221814000_4.1.e000564.12","doi-asserted-by":"publisher","DOI":"10.1253\/circj.68.126"},{"key":"2025081710221814000_4.1.e000564.13","doi-asserted-by":"publisher","DOI":"10.1016\/S1010-7940(99)00137-2"},{"key":"2025081710221814000_4.1.e000564.14","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9149(00)01169-3"},{"key":"2025081710221814000_4.1.e000564.15","doi-asserted-by":"crossref","first-page":"407","DOI":"10.1111\/chd.12153","article-title":"Arrhythmias and sudden death among older children and young adults following Tetralogy of Fallot repair in the current era: are previously reported risk factors still applicable?","volume":"9","author":"Arya","year":"2014","journal-title":"Congenit Heart Dis"},{"key":"2025081710221814000_4.1.e000564.16","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.109.928481"},{"key":"2025081710221814000_4.1.e000564.17","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.91.8.2214"},{"key":"2025081710221814000_4.1.e000564.18","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9149(00)01435-1"},{"key":"2025081710221814000_4.1.e000564.19","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijcard.2013.04.048"},{"key":"2025081710221814000_4.1.e000564.20","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijcard.2012.02.011"},{"key":"2025081710221814000_4.1.e000564.21","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjcard.2010.03.065"},{"key":"2025081710221814000_4.1.e000564.22","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2012.03.077"},{"key":"2025081710221814000_4.1.e000564.23","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.113.001485"},{"key":"2025081710221814000_4.1.e000564.24","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.92.2.231"}],"container-title":["Open Heart"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/openhrt-2016-000564","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,17]],"date-time":"2025-08-17T17:22:21Z","timestamp":1755451341000},"score":1,"resource":{"primary":{"URL":"https:\/\/openheart.bmj.com\/lookup\/doi\/10.1136\/openhrt-2016-000564"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,3]]},"references-count":24,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2017,3,1]]},"published-print":{"date-parts":[[2017,3]]}},"alternative-id":["10.1136\/openhrt-2016-000564"],"URL":"https:\/\/doi.org\/10.1136\/openhrt-2016-000564","relation":{"has-review":[{"id-type":"doi","id":"10.3410\/f.736460071.793564193","asserted-by":"object"}]},"ISSN":["2053-3624"],"issn-type":[{"value":"2053-3624","type":"electronic"}],"subject":[],"published":{"date-parts":[[2017,3]]}}}