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tetralogy of fallot adult

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https://www.readbyqxmd.com/read/28645241/long-term-outcome-after-right-ventricle-to-pulmonary-artery-conduit-surgery-and-reintervention
#1
Kristofer Skoglund, Gunnar Svensson, Ulf Thilén, Mikael Dellborg, Peter Eriksson
BACKGROUND: Reconstruction of the right ventricular outflow tract with a conduit is an established surgical procedure in congenital heart disease and reinterventions are common. OBJECTIVE: An increasing number of patients have a conduit, but there are few population-based studies of long-term outcomes after conduit surgery, reoperations, and transcatheter pulmonary valve replacement. METHODS: In April 2015, all adult patients with a conduit were identified in the Swedish National Registry for Congenital Heart Disease (SWEDCON)...
June 23, 2017: Scandinavian Cardiovascular Journal: SCJ
https://www.readbyqxmd.com/read/28641243/ecurves-a-temporal-shape-encoding
#2
Elena Bernardis, Yong Zhang, Ender Konukoglu, Yangming Ou, Harold Javitz, Leon Axel, Dimitris N Metaxas, Benoit Desjardins, Kilian M Pohl
OBJECTIVE: This paper presents a framework for temporal shape analysis to capture the shape and changes of anatomical structures from 3D+t(ime) medical scans. METHOD: We first encode the shape of a structure at each time point with the spectral signature, i.e., the eigenvalues and eigenfunctions of the Laplace operator. We then expand it to capture morphing shapes by tracking the eigenmodes across time according to the similarity of their eigenfunctions. The similarity metric is motivated by the fact that small shape deformations lead to minor changes in the eigenfunctions...
June 16, 2017: IEEE Transactions on Bio-medical Engineering
https://www.readbyqxmd.com/read/28639972/imaging-in-repaired-tetralogy-of-fallot-with-a-focus-on-recent-advances-in-echocardiography
#3
Guillermo Larios, Mark K Friedberg
PURPOSE OF REVIEW: Imaging is essential for the management of adults with repaired tetralogy of Fallot (rToF). Echocardiography and cardiac magnetic resonance imaging are the central modalities to assess rToF. Here we review recent literature on imaging rToF, focusing on echocardiography and advances in assessment of cardiac mechanics. RECENT FINDINGS: Several two-dimensional, three-dimensional, and Doppler echo parameters have been proposed to assess pulmonary regurgitation, right ventricular volumes and ejection fraction, but most of them still have important limitations in their feasibility and reliability compared to cardiac magnetic resonance (CMR)...
July 20, 2017: Current Opinion in Cardiology
https://www.readbyqxmd.com/read/28634695/assessment-of-early-diastolic-intraventricular-pressure-gradient-in-the-left-ventricle-among-patients-with-repaired-tetralogy-of-fallot
#4
Maki Kobayashi, Ken Takahashi, Mariko Yamada, Kana Yazaki, Kotoko Matsui, Noboru Tanaka, Sachie Shigemitsu, Katsumi Akimoto, Masahiko Kishiro, Keisuke Nakanishi, Shiori Kawasaki, Masaki Nii, Keiichi Itatani, Toshiaki Shimizu
Assessment of left ventricular (LV) dysfunction is vital in patients with repaired tetralogy of Fallot (rTOF). The early diastolic intraventricular pressure gradient (IVPG) in the LV plays an important role in diastolic function. IVPG is calculated as the intraventricular pressure difference divided by the LV length, which allows to account for differences in LV size and therefore calculate IVPG in children. We aimed to investigate the mechanisms of LV diastolic dysfunction by measuring mid-to-apical IVPG as an indicator of the active suction force sucking blood from the left atrium into the LV...
June 20, 2017: Heart and Vessels
https://www.readbyqxmd.com/read/28632651/imaging-in-adult-congenital-heart-disease
#5
Stephanie S Gaydos, Akos Varga-Szemes, Rochelle N Judd, Pal Suranyi, David Gregg
There has been tremendous growth in the population of adults with congenital heart disease (CHD) over the last few decades because of advances in medical care. Whereas some cases are cured during childhood, most patients instead undergo palliation, which leaves them at risk for late complications. Lifelong clinical follow-up involving serial multimodality imaging is helpful to monitor and guide the treatment of late complications. Imaging of these individuals is challenging because of their unique anatomy and therefore requires careful consideration on a case-by-case basis...
July 2017: Journal of Thoracic Imaging
https://www.readbyqxmd.com/read/28628610/outcome-of-cardiac-surgery-in-patients-with-congenital-heart-disease-in-england-between-1997-and-2015
#6
Aleksander Kempny, Konstantinos Dimopoulos, Anselm Uebing, Gerhard-Paul Diller, Ulrich Rosendahl, George Belitsis, Michael A Gatzoulis, Stephen J Wort
BACKGROUND: The number of patients with congenital heart disease (CHD) is increasing worldwide and most of them will require cardiac surgery, once or more, during their lifetime. The total volume of cardiac surgery in CHD patients at a national level and the associated mortality and predictors of death associated with surgery are not known. We aimed to investigate the surgical volume and associated mortality in CHD patients in England. METHODS: Using a national hospital episode statistics database, we identified all CHD patients undergoing cardiac surgery in England between 1997 and 2015...
2017: PloS One
https://www.readbyqxmd.com/read/28623384/the-role-of-cardiopulmonary-exercise-testing-for-decision-making-in-patients-with-repaired-tetralogy-of-fallot
#7
REVIEW
Frederic Dallaire, Rachel M Wald, Ariane Marelli
Tetralogy of Fallot is the most common form of cyanotic congenital heart disease. As a result of the surgical strategies employed at the time of initial repair, chronic pulmonary regurgitation (PR) is prevalent in this population. Despite sustained research efforts, patient selection and timing of pulmonary valve replacement (PVR) to address PR in young asymptomatic patients with repaired tetralogy of Fallot (rToF) remain a fundamental but as yet unanswered question in the field of congenital heart disease...
June 16, 2017: Pediatric Cardiology
https://www.readbyqxmd.com/read/28622727/tetralogy-of-fallot-left-ventricular-clot-aortic-dissection-rare-association
#8
Pankaj Jariwala, Satya Sridhar Kale, Lakshmana Sepur, Edla Arjun Padma Kumar
Cases of uncorrected adult tetralogy of Fallot are rare and mostly manifest secondary to complications. A 30-year-old man presented with progressive breathlessness and severe chest discomfort. Echocardiography revealed tetralogy of Fallot with a left ventricular apical clot and DeBakey type I dissection of the aorta. The patient underwent successful surgical correction. The combination of preoperative complications in the setting of uncorrected tetralogy of Fallot, such as a left ventricular clot and DeBakey type I dissection of the aorta, is very rare...
January 1, 2017: Asian Cardiovascular & Thoracic Annals
https://www.readbyqxmd.com/read/28601469/clinical-course-of-tricuspid-regurgitation-in-repaired-tetralogy-of-fallot
#9
O I Woudstra, J P Bokma, M M Winter, P Kiès, M R M Jongbloed, H W Vliegen, M Groenink, F J Meijboom, B J M Mulder, B J Bouma
BACKGROUND: Little is known on the clinical course of tricuspid regurgitation (TR) in patients with repaired tetralogy of Fallot (rTOF) and which patients are at particular risk. This study aims to determine TR course, characteristics associated with TR progression, and the prognostic relevance of TR in rTOF patients. METHODS: In this dualcenter cohort study, rTOF patients from a prospective national registry with ≥1 cardiac magnetic resonance imaging study and ≥2 echocardiograms available were included...
June 2, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28483478/left-aberrant-subclavian-artery-systematic-study-in-adult-patients
#10
Paweł Tyczyński, Ilona Michałowska, Rafał Wolny, Piotr Dobrowolski, Hubert Łazarczyk, Justyna Rybicka, Piotr Hoffman, Adam Witkowski
BACKGROUND: Left aberrant subclavian artery (LASA), is a type of right aortic arch (RAA) branching, which takes-off distally to the right subclavian artery and usually crosses behind the esophagus to the left upper limb. Taking into account the rarity of RAA, LASA is much more rarely seen than the right aberrant subclavian artery (RASA) originating from the left aortic arch. However, RAA may be associated with much more frequent presence of LASA, than left aortic arch with RASA. Anatomical LASA characteristics were not described up to date...
April 25, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28471080/twenty-years-of-experience-with-intraoperative-pulmonary-artery-stenting
#11
Jeffrey D Zampi, Emefah Loccoh, Aimee K Armstrong, Sunkyung Yu, Ray Lowery, Albert P Rocchini, Jennifer C Hirsch-Romano
OBJECTIVES: To describe our 20-year experience with intraoperative pulmonary artery (PA) stent placement and evaluate long-term patient outcomes, specifically the need and risk factors for reintervention. BACKGROUND: Intraoperative PA stent placement is an alternative to surgical patch arterioplasty and percutaneous angioplasty or stent placement to treat branch PA stenosis. METHODS: We performed a retrospective review of all intraoperative PA stents placed at our institution from 1994-2013...
May 4, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28464509/forced-vital-capacity-predicts-morbidity-and-mortality-in-adults-with-repaired-tetralogy-of-fallot
#12
Katie E Cohen, Matthew W Buelow, Jennifer Dixon, Ruta Brazauskas, Scott B Cohen, Michael G Earing, Salil Ginde
OBJECTIVE: Abnormal lung function characterized by a reduced forced vital capacity (FVC) is common in adults with repaired tetralogy of Fallot (TOF) and is associated with previous thoracotomies and sternotomies. The impact of abnormal lung function on clinical outcomes in adult patients with repaired TOF is unclear. The aim of this study was to determine the impact of abnormal lung function on the outcome of hospitalization and death in adults with repaired TOF when analyzed with other traditional cardiac risk factors...
May 2, 2017: Congenital Heart Disease
https://www.readbyqxmd.com/read/28457242/clinical-aspects-and-ablation-of-ventricular-arrhythmias-in-tetralogy-of-fallot
#13
REVIEW
Katja Zeppenfeld, Adrianus P Wijnmaalen
Life expectancy of patients with rToF has considerably improved due to refined surgical interventions. Monomorphic fast VTs are frequently encountered in adult patients with rToF. The dominant substrate of VT is anatomical isthmuses bordered by surgical incisions, patch material and valve annuli. Substrate based ablation strategies aim to transect all slow conducting anatomical isthmuses (SCAI) as identified by electroanatomical mapping. Procedural success is defined as non-inducibility of VT and confirmed conduction block over the SCAI resulting in long-term VT free survival in most patients...
June 2017: Cardiac Electrophysiology Clinics
https://www.readbyqxmd.com/read/28457237/sudden-cardiac-death-in-adult-congenital-heart-disease
#14
REVIEW
Pablo Ávila, Marie-A Chaix, Blandine Mondésert, Paul Khairy
Sudden death of presumed arrhythmic etiology is a leading cause of mortality in adults with congenital heart disease. Anticipated benefits of the implantable cardioverter-defibrillator (ICD) must be weighed against high complication rates. Without robust evidence from randomized trials, caregivers face difficult decisions in selecting appropriate candidates. Although secondary prevention indications are often clear-cut, risk stratification for primary prevention ICDs is more challenging. Factors associated with sudden death in patients with tetralogy of Fallot are reasonably consistent across studies...
June 2017: Cardiac Electrophysiology Clinics
https://www.readbyqxmd.com/read/28455532/left-ventricular-stiffness-in-adolescents-and-young-adults-with-repaired-tetralogy-of-fallot
#15
Clement Kwong-Man Yu, Wilfred Hing-Sang Wong, Vivian Wing-Yi Li, Yiu-Fai Cheung
Left ventricular (LV) remodeling after tetralogy of Fallot (TOF) repair may influence LV stiffness. We hypothesized that LV stiffness is altered after TOF repair and related to myocardial calibrated integrated backscatter (cIB) and LV diastolic myocardial deformation. Seventy-seven TOF patients and 80 controls were studied. LV stiffness was assessed by diastolic wall strain (DWS) as defined by (LVPWsystole-LVPWdiastole)/LVPWsystole, where LVPW is LV posterior wall thickness, and stiffness index as defined by (E/e/LV end-diastolic dimension), where E and e are respectively early diastolic transmitral inflow and mitral annular velocities...
April 28, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28454836/right-ventricular-dysfunction-in-tetralogy-of-fallot-inhibition-of-the-renin-angiotensin-aldosterone-system-redefine-trial-rationale-and-design-of-a-randomized-double-blind-placebo-controlled-clinical-trial
#16
Jouke P Bokma, Michiel M Winter, Esmée M Kornaat, Hubert W Vliegen, Arie P van Dijk, Joost P van Melle, Folkert J Meijboom, Martijn C Post, Jacqueline K Berbee, Aeilko H Zwinderman, Barbara J M Mulder, Berto J Bouma
Renin-angiotensin-aldosterone system (RAAS) inhibition with angiotensin II receptor blockers or angiotensin-converting enzyme inhibitors is beneficial in patients with acquired left ventricular dysfunction. Adult patients with tetralogy of Fallot (TOF) with right ventricular (RV) dysfunction are at high risk for heart failure, arrhythmias, and sudden cardiac death. However, the efficacy of RAAS inhibition has not been established in these patients. METHODS: The REDEFINE is an investigator-initiated, multicenter, prospective, randomized, double-blind, placebo-controlled trial to study the effects of the angiotensin II receptor blocker losartan (target dosage of 150 mg once daily) in adult patients with TOF...
April 2017: American Heart Journal
https://www.readbyqxmd.com/read/28402450/sudden-cardiac-death-in-adults-with-congenital-heart-disease-does-qrs-complex-fragmentation-discriminate-in-structurally-abnormal-hearts
#17
Jim T Vehmeijer, Zeliha Koyak, Jouke P Bokma, Werner Budts, Louise Harris, Barbara J M Mulder, Joris R de Groot
Aims: Sudden cardiac death (SCD) causes a large portion of all mortality in adult congenital heart disease (ACHD) patients. However, identification of high-risk patients remains challenging. Fragmented QRS-complexes (fQRS) are a marker for SCD in patients with acquired heart disease but data in ACHD patients are lacking. We therefore aim to evaluate the prognostic value of fQRS for SCD in ACHD patients. Methods and results: From a multicentre cohort of 25 790 ACHD patients, we included tachyarrhythmic SCD cases (n = 147), and controls (n = 266) matched by age, gender, congenital defect and (surgical) intervention...
April 10, 2017: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/28364481/postoperative-interventricular-septal-haematoma-following-tetralogy-of-fallot-repair-and-perimembranous-ventricular-septal-defect-repair
#18
Fiona J Bailey, Salim G M Jivanji, Martin Kostolny
Interventricular septal haematoma is a rare postoperative complication in congenital heart surgery. We present one case of a 6-month-old after tetralogy of Fallot repair and 1 case of a 10-month-old after ventricular septal defect repair. Both were noted to have interventricular septal haematoma on intraoperative transoesophageal and postoperative echocardiogram. Although multiple previous reports, mainly in adults, have suggested aggressive intervention, both these cases were managed conservatively, highlighting the management and evolution of a rare postoperative complication in the paediatric population...
February 1, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28347634/ten-year-outcomes-of-monomorphic-ventricular-tachycardia-catheter-ablation-in-repaired-tetralogy-of-fallot
#19
Mikaël Laredo, Robert Frank, Xavier Waintraub, Estelle Gandjbakhch, Laurence Iserin, Sebastien Hascoët, Caroline Himbert, Yves Gallais, Françoise Hidden-Lucet, Guillaume Duthoit
BACKGROUND: Monomorphic ventricular tachycardia (MVT) is common in adults with repaired tetralogy of Fallot (TOF), and is associated with sudden cardiac death. Management of MVT is not defined, and results of catheter ablation (CA) are limited. AIMS: To evaluate long-term outcomes of MVT CA in repaired TOF. METHODS: Thirty-four patients (mean age 32±10.3 years; 59% male) with repaired TOF underwent CA for symptomatic MVT between 1990 and 2012 in our centre; direct-current ablation (DCA) was used in 6%, radiofrequency followed by DCA in 29% and radiofrequency alone in 65%...
March 24, 2017: Archives of Cardiovascular Diseases
https://www.readbyqxmd.com/read/28329231/cardiac-protective-effects-of-remote-ischaemic-preconditioning-in-children-undergoing-tetralogy-of-fallot-repair-surgery-a-randomized-controlled-trial
#20
Qingping Wu, Tingting Wang, Shiqiang Chen, Quanjun Zhou, Haobo Li, Na Hu, Yinglu Feng, Nianguo Dong, Shanglong Yao, Zhengyuan Xia
Aims: Remote ischaemic preconditioning (RIPC) by inducing brief ischaemia in distant tissues protects the heart against myocardial ischaemia-reperfusion injury (IRI) in children undergoing open-heart surgery, although its effectiveness in adults with comorbidities is controversial. The effectiveness and mechanism of RIPC with respect to myocardial IRI in children with tetralogy of Fallot (ToF), a severe cyanotic congenital cardiac disease, undergoing open heart surgery are unclear. We hypothesized that RIPC can confer cardioprotection in children undergoing ToF repair surgery...
February 18, 2017: European Heart Journal
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