22 Fallot patients who had surgery after 21 years of age were thoroughly checked on an average of 11 years postoperatively. The mean functional classification according to the New York Heart Association was 1.5. Hemodynamic studies revealed excellent results. The mean systolic gradient across the pulmonary valve (delta p) was 14 mm Hg at rest and 31 mm Hg during exercise. The data assessed during exercise show that one cannot truly speak of a "total correction". Right ventricular systolic and enddiastolic pressures were elevated as well as the enddiastolic and endsystolic volumes. Right ventricular ejection fraction was significantly diminished (45%). Our results show that there was no significant difference between the patients with or without an outflow tract patch. Pulmonary insufficiency apparently bears no negative influence on long-term prognosis up to 11 years postoperatively in patients operated for tetralogy of Fallot.