Adults who have undergone surgery during childhood to repair a congenital heart defect called tetralogy of Fallot have a satisfactory quality of life, although psychosocial problems and impaired thinking are often present, according to a report in the medical journal Heart.

Tetralogy of Fallot involves four problems: narrowing of the opening from the right side of the heart to the lungs, abnormal thickening of the heart muscles on the right side, an abnormal opening between the right and left side of the heart, and an abnormally positioned aorta, the large blood vessel that exits the heart.

This setup allows some blood to bypass the lungs and not pick up oxygen. This can lead to a whole host of problems and actually cause the patient to assume a bluish appearance. If not corrected with surgery, approximately 70 percent of patients will die by age 10.

Dr. Luciano Daliento, from Policlinico Universitario in Padua, Italy, and colleagues used an interdisciplinary approach to assess quality of life in 54 adults who had tetralogy of Fallot repaired in childhood.

As noted, quality of life was generally satisfactory. However, the authors did identify several adverse psychological characteristics in the group.

The subjects typically achieved a lower academic level than normal and the jobs they held often fell short of their educational level. Moreover, the subjects tended to favor overprotective familiar settings and had difficulty communicating their body image. Denial of their heart condition was also common.

In terms of thinking ability, memory, learning, and attention functions were rarely impaired. However, patients often demonstrated difficulty with problem solving and planning strategies.

“Many factors affect how children with congenital heart disease grow up, such as native cardiac defects, age at operation, type and technique of operation, family setting, and socioeconomic conditions,” the authors state. “Knowledge and awareness of these factors is key in attaining adequate prevention.”

SOURCE: Heart, February 2005.