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tetralogy of fallot adult medic treatment

Alessandro Giamberti, Francesca R Pluchinotta, Massimo Chessa, Alessandro Varrica, Raffaele Vitale, Alessandro Frigiola, Carlo Pappone, Marco Ranucci
AIMS: Supraventricular arrhythmias are a major cause of morbidity and mortality in adult patients with congenital heart disease (CHD). Intraoperative ablation offers an alternative for patients who failed ablation procedures or are requiring concomitant surgical intervention. We present our long-term results with the surgical treatment of arrhythmias in adults with CHD (ACHD) undergoing elective cardiac surgery and the clinical predictors for arrhythmia recurrence. METHODS AND RESULTS: Between 2002 and 2013, 80 consecutive patients with CHD, mean age of 39 years, underwent intraoperative ablation with monopolar irrigated radiofrequency during cardiac surgery procedures...
October 12, 2016: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
Ada C Stefanescu Schmidt, Doreen DeFaria Yeh, Sara Tabtabai, Kevin F Kennedy, Robert W Yeh, Ami B Bhatt
The population of adults with tetralogy of Fallot (TOF) is growing, and it is not known how the changes in age distribution, treatment strategies, and prevalence of co-morbidities impact their interaction with the health care system. We sought to analyze the frequency and reasons for hospital admissions over the past decade. We extracted serial cross-sectional data from the United States Nationwide Inpatient Sample on hospitalizations including the diagnostic code for TOF from 2000 to 2011. From 2000 to 2011, there were 20,545 admissions for subjects with TOF, with a steady increase in annual number...
September 15, 2016: American Journal of Cardiology
Iqbal El-Assaad, Sadeer G Al-Kindi, JoEllyn Abraham, Shubhayan Sanatani, David J Bradley, Colby Halsey, Ian H Law, Seshadri Balaji, Ira Shetty, Peter F Aziz
BACKGROUND: Arrhythmia management has become the major treatment challenge in adult patients with congenital heart disease (ACHD). OBJECTIVE: We sought to investigate the utility and safety profile of dofetilide for atrial arrhythmias in ACHD. METHODS: A retrospective chart review was performed. We included patients (age ≥18 years) with congenital heart disease who had atrial fibrillation (AF) or intra-atrial reentrant tachycardia treated with dofetilide...
October 2016: Heart Rhythm: the Official Journal of the Heart Rhythm Society
Warren A Zuckerman, Marc E Richmond, Teresa M Lee, Emile A Bacha, Paul J Chai, Jonathan M Chen, Linda J Addonizio
OBJECTIVE: To highlight the success of heart transplantation in patients with complex congenital heart disease and physiologic single lung by providing an update on the world's largest reported cohort. METHODS: Demographic, perioperative, postoperative, and outcomes data were collected retrospectively on all patients undergoing heart transplant to single lung at Columbia University Medical Center since 1992, and compared with all other patients undergoing transplants performed for single ventricle or tetralogy of Fallot during that time...
December 2015: Journal of Thoracic and Cardiovascular Surgery
Rachel S Beaty, Brady S Moffett, Stuart Hall, Jeffrey Kim
Cardiac arrhythmias occurring during the intraoperative period for cardiac surgery have been associated with excess morbidity and mortality. Several antiarrhythmics have been utilized for the management of intraoperative arrhythmias. These antiarrhythmic medications can cause undesirable adverse outcomes in the intensive care setting. The incidence and treatment of adult intraoperative arrhythmias have been studied. In addition, the prevalence, risk factors, and optimal treatment of pediatric postoperative arrhythmias have also been studied...
October 2015: Pediatric Cardiology
Mario Carminati, Francesca R Pluchinotta, Luciane Piazza, Angelo Micheletti, Diana Negura, Massimo Chessa, Gianfranco Butera, Carmelo Arcidiacono, Antonio Saracino, Claudio Bussadori
Surgical correction of tetralogy of Fallot is still one of the most frequently performed intervention in pediatric cardiac surgery, and in many cases, it is far from being a complete and definitive correction. It is rather an excellent palliation that solves the problem of cyanosis, but predisposes the patients to medical and surgical complications during follow-up. The decision-making process regarding the treatment of late sequel is among the most discussed topics in adult congenital cardiology. In post-operative Fallot patients, echocardiography is used as the first method of diagnostic imaging and currently allows both a qualitative observation of the anatomical alterations and a detailed quantification of right ventricular volumes and function, of the right ventricular outflow tract, and of the pulmonary valve and pulmonary arteries...
2015: Frontiers in Pediatrics
Miriam Wheeler, Jonathon Leipsic, Philip Trinh, Rekha Raju, Shalan Alaamri, Christopher R Thompson, Robert Moss, Bradley Munt, Marla Kiess, Jasmine Grewal
BACKGROUND: There is little data on right ventricular (RV) remodeling patterns in complex congenital heart disease (CHD) patients with right ventricle to pulmonary artery (PA) conduits, and novel RV imaging modalities have not been explored in this population. Knowledge of the RV remodeling process is an important first step to future understanding and tracking of the RV response to pressure and volume overload in this diverse population. Three-dimensional knowledge-based reconstruction (3DKBR) derived from two-dimensional transthoracic echocardiography (TTE-3DKBR) is a novel approach to RV assessment...
May 2015: Journal of the American Society of Echocardiography
Daniel Jeong, Petros V Anagnostopoulos, Alejandro Roldan-Alzate, Shardha Srinivasan, Mark L Schiebler, Oliver Wieben, Christopher J François
OBJECTIVE: Ventricular kinetic energy measurements may provide a novel imaging biomarker of declining ventricular efficiency in patients with repaired tetralogy of Fallot. Our purpose was to assess differences in ventricular kinetic energy with 4-dimensional flow magnetic resonance imaging between patients with repaired tetralogy of Fallot and healthy volunteers. METHODS: Cardiac magnetic resonance, including 4-dimensional flow magnetic resonance imaging, was performed at rest in 10 subjects with repaired tetralogy of Fallot and 9 healthy volunteers using clinical 1...
May 2015: Journal of Thoracic and Cardiovascular Surgery
Daniel J DiBardino, Jeffrey P Jacobs
As of 2000, more adults than children are alive with congenital heart disease. Each year, more of these adults with congenital heart disease undergo surgery. Adults with congenital heart disease require lifelong surveillance, follow-up imaging, and clinical decision making by appropriately trained and familiar physicians and extenders. Three common challenges facing adults with congenital heart disease are the neglected patient, weak programmatic infrastructure, and the planning and management of pregnancy in the adult with congenital heart disease...
2014: Seminars in Thoracic and Cardiovascular Surgery
Ec Ejim, Bc Anisiuba, Ni Oguanobi, Bc Ubani-Ukoma, Uc Nwaneli, C Ugwu, So Ike
BACKGROUND: Congenital abnormalities of the heart and cardiovascular system are reported in almost 1% of live births, and about half of these children need medical or surgical help in infancy. In the first decade, a further 25% require surgery to maintain or improve their life. Only 10% survive to adolescence without treatment. Of these 10%, however, many live a normal life for years before their abnormality is discovered. AIM: The aim of this study was to find the most common congenital heart diseases in adults presenting for echocardiographic examination in Enugu, and to determine whether there are any gender differences in frequency...
July 2014: Annals of Medical and Health Sciences Research
Koko Adachi, Shin Kurosawa, Eri Kameyama, Yohko Nakata
In Japan, more than 9,000 patients with congenital heart disease reach adulthood every year with improved medical treatment, and perioperative encounter with patients requiring the second intra-cardiac operation in adulthood is more often. Tetralogy of Fallot (TOF) is the most common form of cyanotic congenital heart disease, and long-term prognosis is good. Therefore, we have more chances to care the postoperarive adult patients with TOF. This is a retrospective study in 6 patients with TOF who underwent the second intra-cardiac operation in adulthood from 2008 to 2012...
April 2014: Masui. the Japanese Journal of Anesthesiology
Stéphane Boulé, Lionel Ovart, Christelle Marquié, Edward Botcherby, Didier Klug, Claude Kouakam, François Brigadeau, Laurence Guédon-Moreau, Ludivine Wissocque, Jonathan Meurice, Dominique Lacroix, Salem Kacet
AIMS: To describe obstetric/neonatal and cardiac outcomes for a cohort of women carrying implantable cardioverter-defibrillators (ICDs) during pregnancy. METHODS AND RESULTS: All women in routine follow-up at our institution for ICD implantation who became pregnant between 2006 and 2013 were included in this study. All ICDs were pre-pectoral devices with bipolar endocardial leads. Obstetric/neonatal and cardiac outcomes were assessed during pregnancy and post-partum...
November 2014: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
Timothy Cotts, Paul Khairy, Alexander R Opotowsky, Anitha S John, Anne Marie Valente, Ali N Zaidi, Stephen C Cook, Jamil Aboulhosn, Jennifer Grando Ting, Michelle Gurvitz, Michael J Landzberg, Amy Verstappen, Joseph Kay, Michael Earing, Wayne Franklin, Brian Kogon, Craig S Broberg
BACKGROUND: Adult congenital heart disease (ACHD) clinicians are hampered by the paucity of data to inform clinical decision-making. The objective of this study was to identify priorities for clinical research in ACHD. METHODS: A list of 45 research questions was developed by the Alliance for Adult Research in Congenital Cardiology (AARCC), compiled into a survey, and administered to ACHD providers. Patient input was sought via the Adult Congenital Heart Association at community meetings and online forums...
February 15, 2014: International Journal of Cardiology
Juan Villafañe, George Hamilton Baker, Erle H Austin, Stephen Miller, Lynn Peng, Robert Beekman
OBJECTIVES: The objectives of this manuscript are two-fold: (a) to describe the clinical characteristics and management of four pediatric patients with bacterial endocarditis (BE) after Melody pulmonary valve implantation (MPVI); and (b) to review the literature regarding Melody pulmonary valve endocarditis. BACKGROUND: There are several reports of BE following MPVI. The clinical course, BE management and outcome remain poorly defined. METHODS: This is a multi-center report of four pediatric patients with repaired tetralogy of Fallot (TOF) and BE after MPVI...
August 1, 2014: Catheterization and Cardiovascular Interventions
Richard M Martinez, Jeremy M Ringewald, Hector L Fontanet, James A Quintessenza, Jeffrey P Jacobs
Tetralogy of Fallot is the most common form of cyanotic congenital cardiac disease. Patients with previously repaired tetralogy of Fallot are the most common patients seen in the Program for Adults with Congenital Heart Disease at The Johns Hopkins All Children's Heart Institute. Guidelines for the management of these patients are available from multiple sources including The American College of Cardiology (ACC) and The American Heart Association (AHA), The Canadian Cardiovascular Society, and The European Society of Cardiology (ESC)...
December 2013: Cardiology in the Young
Ditte Mølgaard-Nielsen, Björn Pasternak, Anders Hviid
BACKGROUND: Case reports suggest that long-term, high-dose fluconazole treatment for severe fungal infections during pregnancy causes a pattern of birth defects. It is unclear whether commonly used lower doses increase the risk of specific birth defects. METHODS: In a registry-based cohort of liveborn infants in Denmark, we evaluated first-trimester oral fluconazole exposure and the risk of birth defects overall and of birth defects previously linked to azole antifungal agents...
August 29, 2013: New England Journal of Medicine
Melinda Csáky-Szunyogh, Attila Vereczkey, Zsolt Kósa, Balázs Gerencsér, Andrew E Czeizel
Congenital heart defect (CHD) cases have been evaluated together as a group in some previous epidemiological studies. However, different CHD entities have different etiologies, and the underlying causes are unclear in the vast majority of patients. Thus the aim of this study was to analyze the possible association of different maternal diseases with the risk of four types of conotruncal defects (CTD), that is, truncus arteriosus, d-transposition of the great arteries, tetralogy of Fallot, and double-outlet right ventricle based on autopsy or surgical report diagnosis...
October 2013: American Journal of Medical Genetics. Part A
Peter Kruzliak, Rao P Syamasundar, Miroslav Novak, Olga Pechanova, Gabriela Kovacova
Unilateral absence of pulmonary artery (UAPA) is a rare malformation that can present as an isolated lesion or may be associated with other congenital heart defects. UAPA is often associated with other congenital cardiovascular anomalies, such as tetralogy of Fallot, atrial septal defect, coarctation of aorta, right aortic arch, truncus arteriosus and pulmonary atresia. Diagnosis of UAPA is very difficult and is based on taking a complete medical history, physical examination and imaging examinations. Clinical symptoms include exercise intolerance, haemoptysis and recurrent respiratory infections...
August 2013: Archives of Cardiovascular Diseases
Mary C Niu, Shaine A Morris, David L S Morales, Charles D Fraser, Jeffrey J Kim
To improve outcomes, including arrhythmia incidence, for patients with tetralogy of Fallot (TOF), the authors' institution adopted an approach that minimizes or avoids transmural incision of the right ventricular outflow tract. When pulmonary blood flow is insufficient during the neonatal period, placement of an aortopulmonary artery shunt is preferred, followed by complete repair later in infancy. This study reviewed the perioperative and mid-term arrhythmia outcomes at the authors' institution using this approach...
February 2014: Pediatric Cardiology
Sameer Ahmed, Pamela Tecce Johnson, Elliot K Fishman, Stefan Loy Zimmerman
The population of adults with repaired tetralogy of Fallot (TOF) is growing, thanks to improvements in the surgical and medical management of this condition. Accordingly, late postrepair complications are important medical concerns in these individuals. Initial surgical repair of TOF typically occurs in infancy, consisting of patch repair of the ventricular septal defect (VSD) and relief of right ventricular outflow tract (RVOT) obstruction. Although patients may remain asymptomatic for several decades, the majority will have progressive pulmonic regurgitation that leads to right ventricular (RV) dilatation and functional deterioration...
July 2013: Radiographics: a Review Publication of the Radiological Society of North America, Inc
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