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Repaired Tetralogy of Fallot

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https://www.readbyqxmd.com/read/28904256/current-surgical-outcomes-of-congenital-heart-surgery-for-patients-with-down-syndrome-in-japan
#1
Takaya Hoashi, Norimichi Hirahara, Arata Murakami, Yasutaka Hirata, Hajime Ichikawa, Junjiro Kobayashi, Shinichi Takamoto
BACKGROUND: Current surgical outcomes of congenital heart surgery for patients with Down syndrome are unclear.Methods and Results:Of 29,087 operations between 2008 and 2012 registered in the Japan Congenital Cardiovascular Surgery Database (JCCVSD), 2,651 were carried out for patients with Down syndrome (9%). Of those, 5 major biventricular repair procedures [ventricular septal defect repair (n=752), atrioventricular septal defect repair (n=452), patent ductus arteriosus closure (n=184), atrial septal defect repair (n=167), tetralogy of Fallot (TOF) repair (n=108)], as well as 2 major single ventricular palliations [bidirectional Glenn (n=21) and Fontan operation (n=25)] were selected and their outcomes were compared...
September 12, 2017: Circulation Journal: Official Journal of the Japanese Circulation Society
https://www.readbyqxmd.com/read/28901230/clinical-progress-in-the-management-of-tetralogy-of-fallot-in-the-dominican-republic-a-case-series
#2
María T Perez, Marietta Vázquez, Michael F Canarie, Janet Toribio, Juan León-Wyss
BACKGROUND: Definitive surgical interventions for Dominican children with congenital heart disease, like those of other low- and middle-income countries, have been historically limited. METHODS: We undertook review of a case series focusing on the surgical correction of complex forms of tetralogy of Fallot at a single center, CEDIMAT Centro Cardiovascular, in the Dominican Republic, over a 30-month period. RESULTS: According to our criteria, 43 cases were determined to be complex tetralogy of Fallot repairs from the two-year period...
September 2017: World Journal for Pediatric & Congenital Heart Surgery
https://www.readbyqxmd.com/read/28895301/early-leaflet-thrombosis-complicating-transcatheter-implantation-of-a-sapien-3-valve-in-a-native-right-ventricular-outflow-tract
#3
Mounir Riahi, Philipp Blanke, John Webb, Ronald G Carere
A 59-year-old female with Tetralogy of Fallot had a previous complete repair with RVOT patch enlargement. She developed subsequent severe symptomatic (NYHA III) pulmonary regurgitation with severe RV dilatation. She had a concomitant interstitial lung disease secondary to hypersensitivity pneumonitis that precluded her from cardiac surgery. After preprocedural assessment using computed tomography, echocardiography and invasive angiography we decided to implant a 29 mm Edwards Sapien 3 valve without pre-stenting...
September 12, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28882285/stenting-of-the-right-ventricular-outflow-tract-promotes-better-pulmonary-arterial-growth-compared-with-modified-blalock-taussig-shunt-palliation-in-tetralogy-of-fallot-type-lesions
#4
Daniel Quandt, Bharat Ramchandani, John Stickley, Chetan Mehta, Vinay Bhole, David J Barron, Oliver Stumper
OBJECTIVES: This study sought to compare pulmonary arterial (PA) growth during palliation after right ventricular outflow tract (RVOT) stenting versus modified Blalock-Taussig shunt (mBTS) in patients coming forward for complete repair of tetralogy of Fallot-type lesions. BACKGROUND: RVOT stenting is a recent alternative to mBTS in the initial palliation of selected patients with Fallot-type lesions. METHODS: This was a retrospective, single-center study of nonrandomized, consecutive palliated Fallot patients over a 10-year period...
September 11, 2017: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28880457/development-of-quality-metrics-for-ambulatory-care-in-pediatric-patients-with-tetralogy-of-fallot
#5
Juan Villafane, Thomas C Edwards, Karim A Diab, Gary M Satou, Elizabeth Saarel, Wyman W Lai, Gerald A Serwer, Peter P Karpawich, Russell Cross, Russell Schiff, Devyani Chowdhury, Thomas J Hougen
OBJECTIVE: The objective of this study was to develop quality metrics (QMs) relating to the ambulatory care of children after complete repair of tetralogy of Fallot (TOF). DESIGN: A workgroup team (WT) of pediatric cardiologists with expertise in all aspects of ambulatory cardiac management was formed at the request of the American College of Cardiology (ACC) and the Adult Congenital and Pediatric Cardiology Council (ACPC), to review published guidelines and consensus data relating to the ambulatory care of repaired TOF patients under the age of 18 years...
September 7, 2017: Congenital Heart Disease
https://www.readbyqxmd.com/read/28878577/echocardiographic-classification-and-surgical-approaches-to-double-outlet-right-ventricle-for-great-arteries-arising-almost-exclusively-from-the-right-ventricle
#6
Kun-Jing Pang, Hong Meng, Sheng-Shou Hu, Hao Wang, David Hsi, Zhong-Dong Hua, Xiang-Bin Pan, Shou-Jun Li
Selecting an appropriate surgical approach for double-outlet right ventricle (DORV), a complex congenital cardiac malformation with many anatomic variations, is difficult. Therefore, we determined the feasibility of using an echocardiographic classification system, which describes the anatomic variations in more precise terms than the current system does, to determine whether it could help direct surgical plans. Our system includes 8 DORV subtypes, categorized according to 3 factors: the relative positions of the great arteries (normal or abnormal), the relationship between the great arteries and the ventricular septal defect (committed or noncommitted), and the presence or absence of right ventricular outflow tract obstruction (RVOTO)...
August 2017: Texas Heart Institute Journal
https://www.readbyqxmd.com/read/28877886/pulmonary-right-ventricular-resynchronization-in-congenital-heart-disease-acute-improvement-in-right-ventricular-mechanics-and-contraction-efficiency
#7
Jan Janoušek, Jan Kovanda, Miroslav Ložek, Viktor Tomek, Pavel Vojtovič, Roman Gebauer, Peter Kubuš, Miroslav Krejčíř, Joost Lumens, Tammo Delhaas, Frits Prinzen
BACKGROUND: Electromechanical discoordination may contribute to long-term pulmonary right ventricular (RV) dysfunction in patients after surgery for congenital heart disease. We sought to evaluate changes in RV function after temporary RV cardiac resynchronization therapy. METHODS AND RESULTS: Twenty-five patients aged median 12.0 years after repair of tetralogy of Fallot and similar lesions were studied echocardiographically (n=23) and by cardiac catheterization (n=5) after primary repair (n=4) or after surgical RV revalvulation for significant pulmonary regurgitation (n=21)...
September 2017: Circulation. Cardiovascular Imaging
https://www.readbyqxmd.com/read/28864150/standard-and-strain-measurements-by-echocardiography-detect-early-overloaded-right-ventricular-dysfunction-validation-against-hemodynamic-and-myocyte-contractility-changes-in-a-large-animal-model
#8
Amir Hodzic, Pierre Bobin, Delphine Mika, Mohamed Ly, Florence Lefebvre, Patrick Lechêne, Emmanuel Le Bret, Elodie Gouadon, Mathieu Coblence, Grégoire Vandecasteele, André Capderou, Jérôme Leroy, Catherine Rucker-Martin, Virginie Lambert
BACKGROUND: Early detection of right ventricular (RV) failure is required to improve the management of patients with congenital heart diseases. The aim of this study was to validate echocardiography for the early detection of overloaded RV dysfunction, compared with hemodynamic and myocyte contractility assessment. METHODS: Using a porcine model reproducing repaired tetralogy of Fallot, RV function was evaluated over 4 months using standard echocardiography and speckle-tracking compared with hemodynamic parameters (conductance catheter)...
August 29, 2017: Journal of the American Society of Echocardiography
https://www.readbyqxmd.com/read/28857356/different-predictivity-of-fluid-responsiveness-by-pulse-pressure-variation-in-children-after-surgical-repair-of-ventricular-septal-defect-or-tetralogy-of-fallot
#9
Ding Han, Shoudong Pan, Xiaonan Wang, Qingyan Jia, Yi Luo, Jia Li, Chuan Ou-Yang
BACKGROUND: Pulse pressure variation derived from the varied pulse contour method is based on heart-lung interaction during mechanical ventilation. It has been shown that pulse pressure variation is predictive of fluid responsiveness in children undergoing surgical repair of ventricular septal defect. Right ventricle compliance and pulmonary vascular capacitance in children with tetralogy of Fallot are underdeveloped as compared to those in ventricular septal defect. We hypothesized that the difference in the right ventricle-pulmonary circulation in the two groups of children would affect the heart-lung interaction and therefore pulse pressure variation predictivity of fluid responsiveness following cardiac surgery...
August 31, 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/28856395/quality-of-life-is-diminished-in-patients-with-tetralogy-of-fallot-with-mild-residual-disease-a-comparison-of-tetralogy-of-fallot-and-isolated-valvar-pulmonary-stenosis
#10
Shivani M Bhatt, Elizabeth Goldmuntz, Amy Cassedy, Bradley S Marino, Laura Mercer-Rosa
The objective of this study is to compare quality of life (QOL) in patients with mild pulmonary insufficiency (PI) after Tetralogy of Fallot (TOF) repair or after balloon dilation for isolated valvar pulmonary stenosis (VPS). A cross-sectional study of patients with TOF (n = 12) and VPS (n = 19), ages 8-18 years, who underwent cardiac magnetic resonance (CMR) and cardiopulmonary exercise test (CPET) was conducted. Patients with genetic syndromes were excluded. The groups were matched by severity and duration of PI using propensity scores...
August 31, 2017: Pediatric Cardiology
https://www.readbyqxmd.com/read/28843325/pulmonary-valve-procedures-late-after-repair-of-tetralogy-of-fallot-current-perspectives-and-contemporary-approaches-to-management
#11
REVIEW
Catriona J Bhagra, Edward J Hickey, Alexander Van De Bruaene, S Lucy Roche, Eric M Horlick, Rachel M Wald
Few topics in adult congenital heart disease have approached the level of scrutiny bestowed on pulmonary valve replacement (PVR) strategies late after tetralogy of Fallot (TOF) repair. Despite the successes of primary surgery for TOF, there is a growing group of adults with residual right ventricular outflow tract and pulmonary valve dysfunction. Patients with residual chronic pulmonic regurgitation as a consequence of earlier surgery can later develop symptoms of exercise intolerance and complications including heart failure, tachyarrhythmias, and sudden cardiac death...
September 2017: Canadian Journal of Cardiology
https://www.readbyqxmd.com/read/28814489/right-ventricular-outflow-tract-stent-versus-bt-shunt-palliation-in-tetralogy-of-fallot
#12
Daniel Quandt, Bharat Ramchandani, Gemma Penford, John Stickley, Vinay Bhole, Chetan Mehta, Timothy Jones, David James Barron, Oliver Stumper
OBJECTIVE: This study sets out to compare morbidity, mortality and reintervention rates after stenting of the right ventricular outflow tract (RVOT) versus modified Blalock-Taussig shunt (mBTS) for palliation in patients with tetralogy of Fallot (ToF)-type lesions. METHODS: Retrospective case review study evaluating 101 patients (64 males) with ToF lesions who underwent palliation with either mBTS (n=41) or RVOT stent (n=60) to augment pulmonary blood flow over a 10-year period...
August 16, 2017: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/28803685/quantification-of-pulmonary-regurgitation-by-vector-flow-mapping-in-congenital-heart-patients-after-repair-of-right-ventricular-outflow-obstruction-a-preliminary-study
#13
Ashley Hoi-Man To, Vivian Wing-Yi Li, Ming-Yen Ng, Yiu-Fai Cheung
BACKGROUND: Vector flow mapping (VFM) enables direct visualization of flow pattern and estimation of flow volume. The aim of this study was to determine its accuracy in the quantification of pulmonary regurgitation (PR) in congenital heart patients after repair of right ventricular (RV) outflow obstruction. METHODS: This study comprised two parts: (1) validation of VFM in the quantification of PR in patients with repaired tetralogy of Fallot by cardiac magnetic resonance and (2) clinical application of VFM to determine PR in patients after biventricular repair of pulmonary atresia and stenosis with intact ventricular septum...
August 10, 2017: Journal of the American Society of Echocardiography
https://www.readbyqxmd.com/read/28768675/percutaneous-valve-in-valve-in-the-tricuspid-position-in-a-patient-with-tetralogy-of-fallot
#14
Abhinay Challa, Ryan Markham, Darren Walters
Here, we describe a case of a successful percutaneous insertion of a transcatheter 29 mm Edwards Sapien XT valve into a tricuspid valve in a patient with repaired tetralogy of fallot.Similar procedures have been performed with the Edwards Sapien valve and Melody valves; however, this is the first case described in the literature of an Edwards Sapien valve used in a patient with Tetralogy of Fallot.With procedural safety being demonstrated, this case illustrates an important alternative treatment option for patients with congenital heart disease...
August 2, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28766919/turbulent-kinetic-energy-in-the-right-ventricle-potential-mr-marker-for-risk-stratification-of-adults-with-repaired-tetralogy-of-fallot
#15
Alexandru Fredriksson, Aleksandra Trzebiatowska-Krzynska, Petter Dyverfeldt, Jan Engvall, Tino Ebbers, Carl-Johan Carlhäll
PURPOSE: To assess right ventricular (RV) turbulent kinetic energy (TKE) in patients with repaired Tetralogy of Fallot (rToF) and a spectrum of pulmonary regurgitation (PR), as well as to investigate the relationship between these 4D flow markers and RV remodeling. MATERIALS AND METHODS: Seventeen patients with rToF and 10 healthy controls were included in the study. Patients were divided into two groups based on PR fraction: one lower PR fraction group (≤11%) and one higher PR fraction group (>11%)...
August 2, 2017: Journal of Magnetic Resonance Imaging: JMRI
https://www.readbyqxmd.com/read/28756698/patient-outcomes-after-transcatheter-and-surgical-pulmonary-valve-replacement-for-pulmonary-regurgitation-in-patients-with-repaired-tetralogy-of-fallot-a-quasi-meta-analysis
#16
Marion E McRae, Bernice Coleman, Teresa W Atz, Teresa J Kelechi
BACKGROUND: Individuals with repaired tetralogy of Fallot develop pulmonary regurgitation that may cause symptoms (dyspnea, chest pain, palpitations, fatigue, presyncope, and syncope), impair functional capacity, and may affect health-related quality of life. Surgical pulmonary valve replacement is the gold standard of treatment although transcatheter pulmonary valve replacement is becoming more common. Patients want to know whether less invasive options are as good. AIMS: This analysis aimed to examine the differences in surgical versus transcatheter pulmonary valve replacement effects in terms of physiological/biological variables, symptoms, functional status and health-related quality of life...
August 2017: European Journal of Cardiovascular Nursing
https://www.readbyqxmd.com/read/28741094/systolic-function-of-right-ventricular-outflow-tract-is-a-better-predictor-to-exercise-performance-after-pulmonary-valve-replacement-in-tetralogy-of-fallot
#17
Jianhua Li, Shuhua Luo, Fei Liu, Qi An
Debate on the proper timing of pulmonary valve replacement (PVR) after repair of tetralogy of Fallot is still continuing. We aim to clarify how the different components of right ventricle (RV) changed with relieved volume overload in the remodeling process after pulmonary valve replacement and gain a clear idea of the relationship between different right ventricle components function and exercise capacity after PVR in these patients. The medical records and results of cardiac magnetic resonance imaging and cardiopulmonary exercise testing of 25 consecutive eligible patients were reviewed...
July 24, 2017: Pediatric Cardiology
https://www.readbyqxmd.com/read/28736387/effect-of-pregnancy-on-ventricular-and-aortic-dimensions-in-repaired-tetralogy-of-fallot
#18
Matthew Cauldwell, Michael A Quail, Gillian S Smith, Ee Ling Heng, Sarah Ghonim, Anselm Uebing, Lorna Swan, Wei Li, Roshni R Patel, Dudley J Pennell, Philip J Steer, Mark R Johnson, Michael A Gatzoulis, Sonya V Babu-Narayan
BACKGROUND: The aim was to assess whether cardiovascular adaptation to pregnancy in women with repaired tetralogy of Fallot (TOF) adversely affects hemodynamic stability, in particular with respect to right ventricular (RV) dilatation, pulmonary regurgitation, or aortic root dilatation. METHODS AND RESULTS: This was a retrospective cohort study of women with repaired TOF with paired cardiovascular magnetic resonance scans before and after their first pregnancy (baseline RV end systolic volume index 49 mL/m(2) and RV end diastolic volume index 118 mL/m(2)) matched with a comparison group of nulliparous women with TOF...
July 23, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28734657/exercise-performance-and-22q11-2-deletion-status-affect-quality-of-life-in-tetralogy-of-fallot
#19
Elizabeth Goldmuntz, Amy Cassedy, Laura Mercer-Rosa, Mark A Fogel, Stephen M Paridon, Bradley S Marino
OBJECTIVE: To identify mediators of health status and quality of life (QOL) in children and adolescents aged 8-18 years old following surgical repair for tetralogy of Fallot (TOF), including resource use, exercise performance, and 22q11.2 deletion status. STUDY DESIGN: We performed a corollary study to a cross-sectional analysis of subjects following repair for TOF that completed cardiac magnetic resonance imaging, cardiopulmonary exercise tests, and instruments assessing health status and QOL...
July 19, 2017: Journal of Pediatrics
https://www.readbyqxmd.com/read/28730300/health-related-quality-of-life-in-paediatric-patients-with-congenital-heart-defects-association-with-the-type-of-heart-defect-and-the-surgical-technique
#20
A Heusch, H J Kahl, K O Hensel, G Calaminus
The aim of the study was to investigate the impact of a number of surgical interventions for a various congenital cardiac defects (CHDs) on self-reported HRQoL. METHODS: Patients who had received corrective surgery of several congenital heart defects (surgical VSD closure, Fallot, TGA after atrial or arterial switch or Fontan-type circulation for univentricular AV-connection) were interviewed in the office of their home peadiatric cardiologist. HRQoL in children along 7 dimensions was assessed using a standardised questionnaire (PEDQoL); information on the medical case history of each respondent was also collected...
July 20, 2017: Quality of Life Research
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