Longevity in the Tetralogy of Fallot.

The congenital abnormality of the heart consisting of pulmonary stenosis, ventricular septal defect, and an overriding aorta was described in 1673 by the Danish scholar, Nicolas Stensen (Warburg, 1942). Fallot's (Fallot, 1888) description included right ventricular hypertrophy as an essential part of the malformation. Stensen had made no mention of this, possibly because he reported on the heart of the foetus. Maud Abbott (1936) found in her series of 1,000 cases of congenital heart disease that the average life expectancy in Fallot's tetralogy was 12 years, and only six years in cases with pulmonary artery atresia. In one report on 200 living patients (Donzelot, de Balsac, Emam-Zade, Escalle, and Metianu, 1949) with Fallot's tetralogy, 13 were between the ages of 21 and 30 years and only one over the age of 40. In another report (Soulid, Vernant, Andreuzzi, and Magnoli, 1956) on 144 cases of this malformation, there were eight patients between the ages of 20 and 30, two between 30 and 40, and only two over the age of 40 years. Since the famous case of a musician, reported by White and Sprague (1929), who died in his sixtieth year, 26 other cases have been reported with a survival of more than 40 years. There were four patients between 60 and 70 years (Bain, 1954; Bowie, 1961; Brumlik, 1937; Marquis, 1956), 12 between 50 and 60 years (Abraham, Atkinson, and Mitchell, 1961; Ansell and Reiser, 1957; Bedford, 1956; Campbell, 1958; Feigin and Rosenthal, 1943; Lian and Fleury, 1949; Miller, 1952; Rosenthal, 1956; Soulid et al., 1956; Strandell, 1939; White and Sprague, 1929), and 11 patients between 40 and 50 years of age (Baiguena and Tormo, 1951 ; Civin and Edwards, 1950; Donzelot et al., 1949; Feigin and Rosenthal, 1943; Fisher, Wilson, and Theilen, 1962; Guyot, 1945; Marquis, 1956; Middleton and Ritchie, 1947; Soulid et al., 1956; Volini and Flaxman, 1938; Wood, 1956).