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Repaired Tetralogy of Fallot

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https://www.readbyqxmd.com/read/29330130/perioperative-electrophysiology-study-in-tetralogy-of-fallot-patients-undergoing-pulmonary-valve-replacement-will-identify-those-at-high-risk-for-subsequent-ventricular-tachycardia
#1
Amneet Sandhu, Emily Ruckdeschel, William H Sauer, Kathryn K Collins, Joseph Kay, Amber Khanna, James Jaggers, David Campbell, Max Mitchell, Duy T Nguyen
BACKGROUND: Ventricular tachyarrhythmias (VAs) are the most common cause of death in patients with repaired Tetralogy of Fallot (TOF), but predicting those at risk remains a challenge. Electrophysiological study (EPS) has been proposed to risk stratify TOF patients. OBJECTIVE: We sought to evaluate a perioperative EPS-guided approach to risk stratify TOF patients undergoing PVR and guide concomitant cryoablation. METHODS: A prospective cohort study of TOF patients undergoing EPS at time of PVR from 2006-present was conducted at 2 centers...
January 9, 2018: Heart Rhythm: the Official Journal of the Heart Rhythm Society
https://www.readbyqxmd.com/read/29315865/coronary-artery-bypass-grafting-in-children
#2
Ahmet Arnaz, Tayyar Sarioglu, Yusuf Yalcinbas, Ersin Erek, Riza Turkoz, Ayla Oktay, Arda Saygili, Dilek Altun, Ayse Sarioglu
BACKGROUND: We present our clinical experience with coronary artery bypass grafting (CABG) in children. METHODS: Ten children who underwent CABG between July 1995 and August 2017 were retrospectively analyzed. Data including congenital cardiac malformations, previous surgical procedures, age and sex, type of coronary complications, ischemic events preceding surgery, and ventricular function before and after CABG were recorded. RESULTS: The study population consisted of five males and five females with a median age of 2...
January 7, 2018: Journal of Cardiac Surgery
https://www.readbyqxmd.com/read/29314646/right-ventricular-contractile-reserve-in-tetralogy-of-fallot-patients-with-pulmonary-regurgitation
#3
Clotilde Kingsley, Saad Ahmad, John Pappachan, Sujata Khambekar, Thomas Smith, Diane Gardiner, James Shambrook, Shankar Baskar, Ryan Moore, Gruschen Veldtman
BACKGROUND: The right ventricular (RV) contractile reserve is a measure of the dynamic function of the RV and is a sensitive indicator of volume load. This can be measured noninvasively using the tricuspid annular plane systolic excursion (TAPSE) during exercise. We studied the RV contractile reserve of patients after tetralogy of Fallot (TOF) repair with varying degree of RV dilation and pulmonary regurgitation (PR), and compared them to a control group. METHODS: Twenty-six patients who had undergone TOF repair (mean age 29 ± 10 years) were identified and stratified into three group based on the presence and severity of RV dilation and PR...
January 5, 2018: Congenital Heart Disease
https://www.readbyqxmd.com/read/29312717/predictors-of-ventricular-tachyarrhythmia-occurring-late-after-intracardiac-repair-of-tetralogy-of-fallot-combination-of-qrs-duration-change-rate-and-tricuspid-regurgitation-pressure-gradient
#4
Shuichi Shiraishi, Masashi Takahashi, Ai Sugimoto, Masanori Tsuchida
Background: To determine potential predictors of ventricular tachyarrhythmia and sudden cardiac death (SCD) occurring late after repair of tetralogy of Fallot (TOF). Methods: Since 1964, 415 patients had undergone total repair for TOF at Niigata University Hospital. Of these, 89 patients who were followed for more than 10 years at our institute were retrospectively reviewed. Results: The mean follow-up period was 24.3 years. During the study period, one patient died of cerebral bleeding, and two patients had SCD...
December 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29310562/programmatic-changes-to-reduce-mortality-and-morbidity-in-humanitarian-congenital-cardiac-surgery
#5
Tyler J Wallen, George J Arnaoutakis, Randa Blenden, Rodrigo Soto
BACKGROUND: This report documents the outcomes of cardiac surgical mission trips organized by the International Children's Heart Foundation (ICHF), a nongovernmental organization that provides congenital heart surgery services to the developing world, and discusses factors associated with a reduction of mortality and morbidity in this setting. METHODS: A retrospective review of a prospectively maintained database was conducted to identify any patient who underwent surgical intervention during the course of an ICHF mission trip...
January 2018: World Journal for Pediatric & Congenital Heart Surgery
https://www.readbyqxmd.com/read/29310560/staged-palliation-of-cyanotic-obstructive-lesions-with-a-modified-right-ventricular-outflow-procedure
#6
Sarosh P Batlivala, Mary K Hood, Jannika Dodge-Khatami, Divya Shakti, Mary B Taylor, Makram R Ebeid, Jorge D Salazar, Ali Dodge-Khatami
BACKGROUND: Traditional palliation for biventricular cyanotic congenital heart lesions often involves staging with systemic-to-pulmonary arterial shunts to secure pulmonary blood flow (PBF) in the newborn period prior to complete repair. However, shunts may lead to life-threatening events secondary to shunt occlusion or acute coronary steal. They may be associated with morbidity secondary to diastolic runoff, systemic steal and volume loading, and do not provide pulsatile flow which has the potential to promote pulmonary artery (PA) growth...
January 2018: World Journal for Pediatric & Congenital Heart Surgery
https://www.readbyqxmd.com/read/29310559/arrhythmias-in-children-in-early-postoperative-period-after-cardiac-surgery
#7
Manoj Kumar Sahu, Anupam Das, Bharat Siddharth, Sachin Talwar, Sarvesh Pal Singh, Atul Abraham, Arin Choudhury
BACKGROUND: Postoperative arrhythmias are a known complication after cardiac surgical repairs for congenital heart disease. METHODS: Data were reviewed pertaining to incidence, diagnosis, potential risk factors, and management of postoperative arrhythmias in 369 consecutive patients under 18 years of age, undergoing elective open heart surgery. All children were admitted to the intensive care unit and continuous electrocardiographic monitoring was performed. Patient factors such as Aristotle Basic Complexity Score, total surgical duration, hypotension, tachycardia, serum lactate level, and inotropic score were analyzed...
January 2018: World Journal for Pediatric & Congenital Heart Surgery
https://www.readbyqxmd.com/read/29277931/percutaneous-pulmonary-valve-implantation-in-grown-up-congenital-heart-disease-patients-insights-from-the-zurich-experience
#8
Luca Oechslin, Roberto Corti, Matthias Greutmann, Oliver Kretschmar, Oliver Gaemperli
OBJECTIVES: The aim of the study was to assess indications, procedural success, complications, echocardiographic, and clinical outcomes of percutaneous pulmonary valve implantation (PPVI) in adult patients with congenital heart disease (CHD). BACKGROUND: PPVI offers a non-surgical treatment option for failing prosthetic conduits in pulmonary position. However, efficacy and clinical outcomes after PPVI are still underreported. METHODS: From January 2008 to March 2016, 25 adult CHD patients with right ventricular outflow tract (RVOT) stenosis and/or pulmonary regurgitation underwent PPVI in our institution...
December 25, 2017: Journal of Interventional Cardiology
https://www.readbyqxmd.com/read/29275827/simulation-and-deliberate-practice-in-a-porcine-model-for-congenital-heart-surgery-training
#9
Constantine D Mavroudis, Constantine Mavroudis, Jeffrey P Jacobs, William M DeCampli, James S Tweddell
BACKGROUND: Surgeons in training for congenital cardiac surgery face considerable challenges owing to procedure complexity, closely scrutinized outcomes, and a steep learning curve. Simulation methods have been initiated in other surgical specialties, but have yet to be established for congenital cardiac surgery trainees. The purpose of this study was to assess high-fidelity simulation as a method to train and improve skills of resident trainees learning critical components of index congenital cardiac surgical procedures...
December 21, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29250225/atrial-fibrillation-in-patients-with-congenital-heart-disease
#10
REVIEW
Tabitha G Moe, Victor A Abrich, Edward K Rhee
Advances in surgical techniques have led to the survival of most patients with congenital heart disease (CHD) up to their adulthood. During their lifetime, many of them develop atrial tachyarrhythmias due to atrial dilatation and scarring from surgical procedures. More complex defects and palliative repairs are linked to a higher incidence and earlier occurrence of arrhythmias. Atrial fibrillation (AF) is common in patients who have atrial septal defects repaired after age 55 and in patients with tetralogy of Fallot repaired after age 45...
June 2017: Journal of Atrial Fibrillation
https://www.readbyqxmd.com/read/29245201/effect-of-administration-of-allopurinol-on-postoperative-outcomes-in-patients-undergoing-intracardiac-repair-of-tetralogy-of-fallot
#11
Sachin Talwar, Murugan Sathiya Selvam, Neeti Makhija, Ramakrishnan Lakshmy, Shiv Kumar Choudhary, Vishnubhatla Sreenivas, Balram Airan
OBJECTIVE: To determine effects of allopurinol administration on outcomes following intracardiac repair of tetralogy of Fallot (TOF). MATERIALS AND METHODS: Fifty patients undergoing TOF repair were randomized to 2 groups of 25 each: the allopurinol group (n = 25) and the placebo group (n = 25). Postoperatively, inotropic score, rhythm, duration of mechanical ventilation, cardiac output, intensive care unit (ICU) stay, and hospital stay were assessed. Plasma troponin-I, superoxide dismutase (SOD), interleukin (IL) 1-ß, IL-6, and malondialdehyde were measured serially...
January 2018: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29240000/complete-versus-staged-repair-for-neonates-with-tetralogy-of-fallot-establishment-and-validation-of-a-cohort-of-2235-patients-using-detailed-surgery-sequence-review-of-health-care-administrative-data
#12
Jill J Savla, Brian T Fisher, Jennifer A Faerber, Yuan-Shung V Huang, Laura Mercer-Rosa
BACKGROUND: The surgical strategy for neonates with tetralogy of Fallot (TOF) consists of complete or staged repair. Assessing the comparative effectiveness of these approaches is facilitated by a large multicenter cohort. We propose a novel process for cohort assembly using the Pediatric Health Information System (PHIS), an administrative database that contains clinical and billing data for inpatient and emergency department stays from tertiary children's hospitals. METHODS: A 4-step process was used to identify neonates with TOF: (1) screen neonates in PHIS with International Classification of Diseases-9 (ICD-9) diagnosis or procedure codes for TOF; (2) include patients with TOF procedures before 30 days of age; (3) exclude patients with missing 2-year follow-up data; (4) analyze patients' 2-year surgery sequence patterns, exclude patients inconsistent with a treatment strategy for TOF, and designate patients as complete or staged repair...
December 12, 2017: Medical Care
https://www.readbyqxmd.com/read/29238854/effect-of-weight-extremes-on-ventricular-volumes-and-myocardial-strain-in-repaired-tetralogy-of-fallot-as-measured-by-cmr
#13
Scott A Simpson, Suzanne L Field, Meng Xu, Benjamin R Saville, David A Parra, Jonathan H Soslow
Pulmonary valve replacement (PVR) in patients with repaired tetralogy of Fallot (rTOF-TAP) is often based on cardiac MRI (CMR) right ventricular (RV) volumes indexed to body surface area (BSA). Weight extremes result in increased patient morbidity and affect indexed measurements. We hypothesized that patients with rTOF-TAP at extremes of weight have (1) over- or underestimated indexed volumes and (2) altered parameters of cardiac function. CMRs in patients with rTOF-TAP were retrospectively reviewed; analysis included right and left ventricular (LV) volumes and ejection fractions (EF) and peak global LV circumferential strain (ε cc) from myocardial tagged images...
December 14, 2017: Pediatric Cardiology
https://www.readbyqxmd.com/read/29233764/annulus-sparing-tetralogy-of-fallot-repair-low-risk-and-benefits-to-right-ventricular-geometry
#14
Edward Hickey, Eric Pham-Hung, Fredrick Halvorsen, Michael Gritti, An Duong, Travis Wilder, Christopher Caldarone, Andrew Redington, Glen Van Arsdell
BACKGROUND: Annulus-sparing (AS) repair of tetralogy of Fallot (TOF) carries a potential increased risk reoperation for re-stenosis and unproven benefits on right ventricular (RV) geometry. METHODS: Primary TOF repairs (N=434) between 2000 and 2012 were studied using risk-adjusted parametric techniques. Progression of cardiac dimensions were analyzed using repeated measures regression using reports of all 2,103 echocardiograms undertaken throughout the study period, to maximum follow-up 13...
December 9, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29232281/cross-sectional-areas-of-the-thoracic-aorta-in-children-and-adolescents-with-repaired-tetralogy-of-fallot-obtained-by-cardiac-magnetic-resonance-angiography
#15
Daniel Gräfe, Matthias Gutberlet, Meinhard Mende, Ingo Dähnert, Christian Lücke, Martin Kostelka, Stefan Nitzsche, Janine Hoffmann, Matthias Grothoff
PURPOSE: Dilatation of the thoracic aorta is a well-known finding in corrected Tetralogy of Fallot. Complications are rare but can be life-threatening. Standard 1-dimensional (1D) measurements have several limitations. We sought to establish contrast-enhanced magnetic resonance angiography cross-sectional areas of the aorta that could serve as reference values and to identify parameters that are associated with aortic dilatation. MATERIALS AND METHODS: We enrolled 101 children and adolescents...
December 11, 2017: Journal of Thoracic Imaging
https://www.readbyqxmd.com/read/29230261/early-experience-with-open-heart-surgery-in-a-pioneer-private-hospital-in-west-africa-the-biket-medical-centre-experience
#16
Uvie Ufuoma Onakpoya, Adebisi David Adenle, Anthony Taiwo Adenekan
Introduction: More than forty years after the first open heart surgery in Nigeria, all open heart surgeries were carried out in government-owned hospitals before the introduction of such surgeries in 2013 at Biket Medical Centre, a privately owned hospital in Osogbo, South-western Nigeria. The aim of this paper is to review our initial experience with open heart surgery in this private hospital. Methods: All patients who underwent open heart surgery between August 2013 and January 2014 were included in this prospective study...
2017: Pan African Medical Journal
https://www.readbyqxmd.com/read/29228952/association-between-left-ventricular-mechanics-and-diffuse-myocardial-fibrosis-in-patients-with-repaired-tetralogy-of-fallot-a-cross-sectional-study
#17
Christopher M Haggerty, Jonathan D Suever, Arichanah Pulenthiran, Abba Mejia-Spiegeler, Gregory J Wehner, Linyuan Jing, Richard J Charnigo, Brandon K Fornwalt, Mark A Fogel
BACKGROUND: Patients with repaired tetralogy of Fallot (TOF) have progressive, adverse biventricular remodeling, leading to abnormal contractile mechanics. Defining the mechanisms underlying this dysfunction, such as diffuse myocardial fibrosis, may provide insights into poor long-term outcomes. We hypothesized that left ventricular (LV) diffuse fibrosis is related to impaired LV mechanics. METHODS: Patients with TOF were evaluated with cardiac magnetic resonance in which modified Look-Locker (MOLLI) T1-mapping and spiral cine Displacement encoding (DENSE) sequences were acquired at three LV short-axis positions...
December 11, 2017: Journal of Cardiovascular Magnetic Resonance
https://www.readbyqxmd.com/read/29225904/late-stage-left-ventricular-dysfunction-in-adult-survivors-of-tetralogy-of-fallot-repair-in-childhood
#18
Abdel Anabtawi, Judith Mondragon, Diane Dodendorf, Warren K Laskey
Objective: Left ventricular systolic dysfunction (LVSD) in adult survivors of tetralogy of Fallot (TOF) repair in childhood has been observed, although the relationship with long-term outcome remains inadequately described. Methods: A cohort of 44 consecutive adult patients with TOF repair in childhood were followed prospectively from January 2001 through June 2016. LVSD was defined as an echocardiographically derived left ventricular (LV) ejection fraction <0...
2017: Open Heart
https://www.readbyqxmd.com/read/29223833/valve-sparing-repair-with-intraoperative-balloon-dilation-in-tetralogy-of-fallot-midterm-results-and-therapeutic-implications
#19
Sophie C Hofferberth, Meena Nathan, Gerald R Marx, Minmin Lu, Lynn A Sleeper, Audrey C Marshall, Christopher W Baird, John E Mayer, Pedro J Del Nido, Sitaram M Emani
OBJECTIVES: The significant morbidity of long-term pulmonary regurgitation (PR) has driven the development of pulmonary valve (PV) sparing repair strategies in patients with tetralogy of Fallot (ToF). We assessed mid-term PV function in patients who underwent primary ToF repair with valve-sparing intraoperative balloon dilation (IBD) technique. METHODS: We evaluated 162 consecutive patients with ToF and pulmonary stenosis (ToF-PS) who underwent valve-sparing repair with IBD under 1 year of age...
November 13, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29222139/effect-of-losartan-on-rv-dysfunction-results-from-the-double-blind-randomized-redefine-trial-in-adults-with-repaired-tetralogy-of-fallot
#20
Jouke P Bokma, Michiel M Winter, Arie P van Dijk, Hubert W Vliegen, Joost P van Melle, Folkert Meijboom, Martijn C Post, Jacqueline K Berbee, S Matthijs Boekholdt, Maarten Groenink, Aeilko H Zwinderman, Barbara J M Mulder, Berto J Bouma
Background -The effect of angiotensin II receptor blockers (ARBs) on right ventricular (RV) function is still unknown. ARBs are beneficial in patients with acquired left ventricular (LV) dysfunction and recent findings suggested a favorable effect in symptomatic patients with systemic RV dysfunction. The current study aimed to determine the effect of losartan, an ARB, on subpulmonary RV dysfunction in adults after repair of tetralogy of Fallot (rTOF). Methods -REDEFINE is an investigator-initiated, multicenter, prospective, 1:1 randomized, double-blind, placebo-controlled study...
December 8, 2017: Circulation
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