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Repaired Tetralogy of Fallot

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https://www.readbyqxmd.com/read/29786408/impact-of-additional-tricuspid-valve-annuloplasty-in-tof-patients-undergoing-pulmonary-valve-replacement
#1
Sabrina Lueck, Eike Bormann, Kathrin Rellensmann, Sven Martens, Andreas Rukosujew
BACKGROUND: Many patients with tetralogy of Fallot (TOF) who underwent surgical correction of their congenital cardiac malformation during infancy develop right ventricular dysfunction and exercise intolerance in the long term. The right ventricle (RV) dilates due to the development of severe pulmonary regurgitation (and secondary tricuspid insufficiency). To reduce RV dilation and improve exercise tolerance pulmonary valve replacement (PVR) is the common therapeutic strategy. Whether concomitant tricuspid valve repair (TVR) is beneficial in these pure volume-overload conditions is still unknown...
May 22, 2018: Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/29779123/pulmonary-valve-replacement-after-repaired-tetralogy-of-fallot
#2
REVIEW
Hideki Tatewaki, Akira Shiose
In this review article, we describe pulmonary valve replacement (PVR) late after repaired Tetralogy of Fallot (TOF). Since the introduction of surgical intervention for patients with TOF in 1945, surgical management of TOF has dramatically improved early survival with mortality rates, less than 2-3%. However, the majority of these patients continue to experience residual right ventricular outflow tract pathology, most commonly pulmonary valve regurgitation (PR). The patients are generally asymptomatic during childhood and adolescence and, however, are at risk for severe PR later which can result in exercise intolerance, heart failure, arrhythmias, and sudden death...
May 19, 2018: General Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29776810/congenital-heart-disease-in-adults-assessmentof-functional-capacity-using-cardiopulmonary-exercise-testing
#3
Sílvia Aguiar Rosa, Ana Agapito, Rui M Soares, Lídia Sousa, José Alberto Oliveira, Ana Abreu, Ana Sofia Silva, Sandra Alves, Helena Aidos, Fátima F Pinto, Rui Cruz Ferreira
AIM: The aim of the study was to compare functional capacity in different types of congenital heart disease (CHD), as assessed by cardiopulmonary exercise testing (CPET). METHODS: A retrospective analysis was performed of adult patients with CHD who had undergone CPET in a single tertiary center. Diagnoses were divided into repaired tetralogy of Fallot, transposition of the great arteries (TGA) after Senning or Mustard procedures or congenitally corrected TGA, complex defects, shunts, left heart valve disease and right ventricular outflow tract obstruction...
May 15, 2018: Portuguese Journal of Cardiology: An Official Journal of the Portuguese Society of Cardiology
https://www.readbyqxmd.com/read/29769202/predictors-of-length-of-hospital-stay-after-complete-repair-for-tetralogy-of-fallot-a-prospective-cohort-study
#4
Laura Mercer-Rosa, Okan U Elci, Grace DeCost, Stacy Woyciechowski, Sharon M Edman, Chitra Ravishankar, Christopher E Mascio, Steven M Kawut, Elizabeth Goldmuntz
BACKGROUND: We sought to identify patient and surgical factors associated with time to hospital discharge in patients undergoing complete repair for tetralogy of Fallot. METHODS AND RESULTS: We performed a prospective cohort study of patients with tetralogy of Fallot admitted for complete repair between May 1, 2012 and June 2, 2017 at Children's Hospital of Philadelphia with detailed demographic, clinical, and operative characteristics. The primary outcome was time to hospital discharge...
May 16, 2018: Journal of the American Heart Association
https://www.readbyqxmd.com/read/29767292/short-axis-diastolic-ventricular-area-ratio-as-a-new-index-in-screening-patients-with-repaired-tetralogy-of-fallot
#5
Dala Zakaria, Sean Lang, Mallikarjuna Rettiganti, Jeffrey M Gossett, Elijah Bolin, R Thomas Collins
Right ventricular (RV) end-diastolic volume measured by cardiovascular magnetic resonance imaging (CMR) is a criterion for pulmonary valve replacement in patients with tetralogy of Fallot (TOF). We sought to determine if the ratio of echocardiographic, short-axis RV-to-left ventricular (LV) end-diastolic areas (EDA) could be used to predict RV volume on CMR. We retrospectively reviewed the echocardiograms of all patients with repaired TOF who underwent CMR at our institution from 2011 to 2015 and also had an echocardiogram within 6 months of the CMR...
May 16, 2018: Pediatric Cardiology
https://www.readbyqxmd.com/read/29761422/computational-pre-surgical-planning-of-arterial-patch-reconstruction-parametric-limits-and-in-vitro-validation
#6
S Samaneh Lashkarinia, Senol Piskin, Tijen A Bozkaya, Ece Salihoglu, Can Yerebakan, Kerem Pekkan
Surgical treatment of congenital heart disease (CHD) involves complex vascular reconstructions utilizing artificial and native surgical materials. A successful surgical reconstruction achieves an optimal hemodynamic profile through the graft in spite of the complex post-operative vessel growth pattern and the altered pressure loading. This paper proposes a new in silico patient-specific pre-surgical planning framework for patch reconstruction and investigates its computational feasibility. The proposed protocol is applied to the patch repair of main pulmonary artery (MPA) stenosis in the Tetralogy of Fallot CHD template...
May 14, 2018: Annals of Biomedical Engineering
https://www.readbyqxmd.com/read/29760475/computed-tomography-for-evaluating-right-ventricle-and-pulmonary-artery-in-pediatric-tetralogy-of-fallot-correlation-with-post-operative-pulmonary-regurgitation
#7
Yue Gao, Zhi-Gang Yang, Ke Shi, Kai-Yue Diao, Hua-Yan Xu, Ying-Kun Guo
Pulmonary regurgitation (PR) is the most common complication after tetralogy of Fallot (TOF) surgical repair, and long-term PR might result in cardiovascular events. The aim of this study was to assess the influence of pre-operative right ventricle (RV) and pulmonary artery (PA) parameters assessed by dual-source computed tomography on post-operative PR. A total of 41 TOF patients who underwent trans-valve surgical repair were retrospectively recruited. The RV and PA parameters evaluated by pre-operative DSCT were compared between the PR and non-PR groups...
May 14, 2018: Scientific Reports
https://www.readbyqxmd.com/read/29748395/considerations-in-pursuing-the-optimal-timing-for-pulmonary-valve-replacement-in-repaired-tetralogy-of-fallot
#8
Kai Ma, Guanxi Wang, Shoujun Li
No abstract text is available yet for this article.
June 2018: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/29739232/comparison-of-the-coagulation-effect-achieved-by-octaplaslg-versus-fresh-frozen-plasma-in-pediatric-cardiac-surgical-patients
#9
Amanpreet S Kalsi, Omar Al-Azzawi, Ravi Gill
OctaplasLG is indicated for use in patients undergoing cardiac surgery who require replacement of multiple clotting factors. The use of OctaplasLG over single-donor fresh frozen plasma (FFP) may have beneficial effects when considering the transmission of enveloped viruses. Additionally, it has the potential for fewer adverse reactions, reduced disease transmission, and a more homogenous coagulation factor composition. However, its efficacy and safety have not yet been evaluated in the pediatric population...
January 1, 2018: Clinical and Applied Thrombosis/hemostasis
https://www.readbyqxmd.com/read/29720396/primary-repair-versus-surgical-and-transcatheter-palliation-in-infants-with-tetralogy-of-fallot
#10
Dan M Dorobantu, Alireza S Mahani, Mansour T A Sharabiani, Ragini Pandey, Gianni D Angelini, Andrew J Parry, Robert M R Tulloh, Robin P Martin, Serban C Stoica
OBJECTIVES: Treatment of infants with tetralogy of Fallot (ToF) has evolved in the last two decades with increasing use of primary surgical repair (PrR) and transcatheter right ventricular outflow tract palliation (RVOTd), and fewer systemic-to-pulmonary shunts (SPS). We aim to report contemporary results using these treatment options in a comparative study. METHODS: This a retrospective study using data from the UK National Congenital Heart Disease Audit. All infants (n=1662, median age 181 days) with ToF and no other complex defects undergoing repair or palliation between 2000 and 2013 were considered...
May 2, 2018: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/29697045/an-unexpected-case-of-post-operative-superior-caval-vein-syndrome
#11
Lynn Peng, Lisa Wise-Faberowski
Superior caval vein obstruction in children after congenital heart surgery has been more associated with thrombosis formation as result of single-ventricle palliation, infection, indwelling devices/catheters, or external compression. Many of these patients will present to the cardiac catheterisation laboratory for evaluation and possible intervention. We present an unusual case of superior caval vein obstruction in a patient after Tetralogy of Fallot repair.
April 26, 2018: Cardiology in the Young
https://www.readbyqxmd.com/read/29697020/optimal-use-of-z-scores-to-preserve-the-pulmonary-valve-annulus-during-repair-of-tetralogy-of-fallot
#12
Mark Nelson Awori, Nikita P Mehta, Frederick O Mitema, Naomi Kebba
OBJECTIVE: The size of the pulmonary annulus measured as a z-score is often used to determine when to insert a transannular patch (TAP). Multiple "cutoffs" are quoted in the literature; this could lead to inappropriate insertion. We aimed to determine whether the use of z-scores derived from different populations may have contributed to the varied "cutoffs" quoted. METHODS: PubMed was searched using the terms: "tetralogy," "Fallot," "transannular," "patch," "mortality," and "death...
May 2018: World Journal for Pediatric & Congenital Heart Surgery
https://www.readbyqxmd.com/read/29686545/effects-of-eplerenone-on-markers-of-myocardial-fibrosis-6-minute-walk-distance-and-quality-of-life-in-adults-with-tetralogy-of-fallot-and-complete-transposition-of-the-great-arteries
#13
Sandeep S Sodhi, Tony J Zhang, Rachel McDonald, Vanessa Al Rashida, Nitin Kondapalli, Philip Barger, Philip Ludbrook, Ari M Cedars
Ventricular dysfunction is common among patients with repaired cyanotic congenital heart disease. To date, no pharmacologic intervention has been demonstrated to be beneficial in this setting. To begin addressing this knowledge gap, we conducted a single-center prospective, randomized, open-label pilot study to investigate the effects of eplerenone on serologic markers of collagen turnover and inflammation, 6-minute walk distance, and quality of life in patients with tetralogy of Fallot (TOF) or transposition of the great arteries with a systemic right ventricle (transposition of the great arteries [TGA])...
January 2018: Proceedings of the Baylor University Medical Center
https://www.readbyqxmd.com/read/29678339/usefulness-of-pulmonary-arterial-end-diastolic-forward-flow-late-after-tetralogy-of-fallot-repair-to-predict-a-restrictive-right-ventricle
#14
Shelby Kutty, Anne Marie Valente, Matthew T White, Kelsey Hickey, David A Danford, Andrew J Powell, Tal Geva
The functional significance of pulmonary arterial end-diastolic forward flow (EDFF) in patients with repaired tetralogy of Fallot (rTOF) is not fully understood, with conflicting reports regarding its associations with pulmonary regurgitation (PR), right ventricular (RV) size and function, and so-called restrictive RV physiology. To examine these associations, we retrospectively analyzed 399 patients with rTOF who had contemporaneous echocardiography (Echo) and cardiovascular magnetic resonance (CMR) studies...
March 7, 2018: American Journal of Cardiology
https://www.readbyqxmd.com/read/29673853/biventricular-dyssynchrony-on-cardiac-magnetic-resonance-imaging-and-its-correlation-with-myocardial-deformation-ventricular-function-and-objective-exercise-capacity-in-patients-with-repaired-tetralogy-of-fallot
#15
Pantelis Kalaitzidis, Stefan Orwat, Aleksander Kempny, Radke Robert, Brigitte Peters, Samir Sarikouch, Philipp Beerbaum, Helmut Baumgartner, Gerhard-Paul Diller
BACKGROUND: Electrical dyssynchrony and prolonged QRS duration are common in patients with repaired tetralogy of Fallot (ToF). It has been linked to increased risk of sudden cardiac death and right ventricular (RV) dysfunction. We investigated myocardial dyssynchrony using cardiac magnetic resonance imaging (CMR) and feature tracking analysis (FT) in this setting and compared it to myocardial deformation, conventional parameters of ventricular dysfunction and clinical parameters. METHODS AND RESULTS: Patients underwent standardized CMR investigations as part of a nationwide study...
April 12, 2018: International Journal of Cardiology
https://www.readbyqxmd.com/read/29666995/disturbed-left-and-right-ventricular-kinetic-energy-in-patients-with-repaired-tetralogy-of-fallot-pathophysiological-insights-using-4d-flow-mri
#16
Pia Sjöberg, Sebastian Bidhult, Jelena Bock, Einar Heiberg, Håkan Arheden, Ronny Gustafsson, Shahab Nozohoor, Marcus Carlsson
OBJECTIVES: Indications for pulmonary valve replacement (PVR) in patients with pulmonary regurgitation (PR) after repaired tetralogy of Fallot (rToF) are debated. We aimed to compare right (RV) and left ventricular (LV) kinetic energy (KE) measured by 4D-flow magnetic resonance imaging (MRI) in patients to controls, to further understand the pathophysiological effects of PR. METHODS: Fifteen patients with rToF with PR > 20% and 14 controls underwent MRI. Ventricular volumes and KE were quantified from cine MRI and 4D-flow, respectively...
April 17, 2018: European Radiology
https://www.readbyqxmd.com/read/29657239/application-of-a-fresh-decellularized-pulmonary-allograft-for-pulmonary-valve-replacement-in-japan
#17
Hideto Ozawa, Takayoshi Ueno, Masaki Taira, Koichi Toda, Toru Kuratani, Yoshiki Sawa
BACKGROUND: Tissue engineering has advanced the technique of decellularization of the heart valve. The valve is reseeded with the patient's own cells after implantation with suppression of immunologic reactions. The same advantage has been reported for fresh decellularized heart valves, and more than 10 years of excellent outcomes have been achieved. We began performing such heart valve implantations in 2013 as part of a clinical study at Osaka University. We report our evaluation of the safety and efficacy of heart valve implantation...
April 14, 2018: Circulation Journal: Official Journal of the Japanese Circulation Society
https://www.readbyqxmd.com/read/29644405/abnormalities-in-left-ventricular-rotation-are-inherent-in-young-children-with-repaired-tetralogy-of-fallot-and-are-independent-of-right-ventricular-dilation
#18
Ruchika Karnik, Santosh C Uppu, Meghan Tozzi, John Doucette, Irene D Lytrivi, Miwa Geiger, Berthold Klas, Ira A Parness, Rajesh Shenoy, Hari Rajagopal, Shubhika Srivastava
Left ventricular (LV) dysfunction is a risk factor for adverse outcomes in older children and adults with repaired Tetralogy of Fallot (rToF). Pulmonary regurgitation (PR), right ventricular (RV) dilation, and dysfunction have been shown to result in abnormal LV myocardial mechanics and dysfunction. The aim of our study was to evaluate LV rotational mechanics, especially apical rotation in young children with rToF with and without RV dilation. This is a retrospective, single center study in 28 asymptomatic young children with rToF (16 with RV dilation; 12 without RV dilation); 29 age-matched normal controls...
April 11, 2018: Pediatric Cardiology
https://www.readbyqxmd.com/read/29627138/longitudinal-changes-in-right-ventricular-function-in-tetralogy-of-fallot-in-the-initial-years-after-surgical-repair
#19
Michael P DiLorenzo, Okan U Elci, Yan Wang, Anirban Banerjee, Tomoyuki Sato, Bonnie Ky, Elizabeth Goldmuntz, Laura Mercer-Rosa
BACKGROUND: Right ventricular (RV) dysfunction is associated with adverse long-term outcomes in patients with tetralogy of Fallot. Little is known about RV function in the first years after surgical repair. The aim of this study was to investigate perioperative changes in myocardial deformation using global longitudinal strain. METHODS: A retrospective analysis of patients with surgically repaired tetralogy of Fallot was performed. Global longitudinal peak systolic RV strain was measured on early postoperative echocardiograms, two subsequent postoperative echocardiograms through 2 years postoperatively, and preoperative echocardiograms, when available...
April 4, 2018: Journal of the American Society of Echocardiography
https://www.readbyqxmd.com/read/29617802/tetralogy-of-fallot-with-critical-biventricular-dysfunction-is-surgical-correction-achievable
#20
Grégoire Cousin, Miarisoa Ratsimandresy, Bertrand Leobon, Fabio Cuttone
We describe the case of a 32-month-old patient from a developing country with tetralogy of Fallot associated with a severe biventricular dysfunction. This association is rare but makes the surgical strategy complex and potentially contraindicated. An acute severe hypoxic episode led us to perform palliative rescue intervention involving the placement of an undersized systemic-to-pulmonary shunt. This surgery was well tolerated and allowed a fast and impressive recovery of the ventricular function, making complete repair possible...
April 2, 2018: Interactive Cardiovascular and Thoracic Surgery
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