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Repaired Tetralogy of Fallot

Anitha Parthiban, Jami C Levine, Meena Nathan, Jennifer A Marshall, Girish S Shirali, Stephen D Simon, Steven D Colan, Jane W Newburger, Geetha Raghuveer
BACKGROUND: Postoperative echocardiography after congenital heart disease surgery is of prognostic importance, but variable image quality is problematic. We implemented a quality improvement bundle comprising of focused imaging protocols, procedural sedation, and sonographer education to improve the rate of optimal imaging (OI). METHODS: Predischarge echocardiograms were evaluated in 116 children (median age, 0.51 years; range, 0.01-5.6 years) from two centers after tetralogy of Fallot repair, arterial switch operation, and bidirectional Glenn and Fontan procedures...
October 11, 2016: Journal of the American Society of Echocardiography
Woo Sung Jang, Joon Yong Cho, Jong Uk Lee, Youngok Lee
BACKGROUND: Monocusp reconstruction with a transannular patch (TAP) results in early improvement because it relieves residual volume hypertension during the immediate postoperative period. However, few reports have assessed the long-term surgical outcomes of this procedure. The purpose of the present study was to evaluate the mid-term surgical outcomes of tetralogy of Fallot (TOF) repair using monocusp reconstruction with a TAP. METHODS: Between March 2000 and March 2009, 36 patients with a TOF received a TAP...
October 2016: Korean Journal of Thoracic and Cardiovascular Surgery
Byung Won Yoo, Han Ki Park
[This corrects the article on p. 235 in vol. 56, PMID: 23807889.].
September 2016: Korean Journal of Pediatrics
Maruti Yamanappa Haranal, Joseph Xavier, Vivek Jawali, Ashish Madkaiker
Coronary artery disease developing in tetralogy of Fallot (TOF) is rare. We report a rare case of TOF with acquired coronary artery disease, treated simultaneously with intra cardiac repair and multi vessel coronary artery bypass grafting.
October 6, 2016: Journal of Cardiac Surgery
Michael E A Cunningham, Mary T Donofrio, Syed Murfad Peer, David Zurakowski, Richard A Jonas, Pranava Sinha
BACKGROUND: We have previously demonstrated that early primary repair of tetralogy of Fallot with pulmonary stenosis (TOF) can be safely performed without increase in hospital resource utilization or compromise to surgical technical performance scores (TPS). We sought to identify the optimal timing for elective early primary repair of TOF with respect to intermediate-term reintervention. METHODS: Retrospective review of all patients with TOF undergoing elective primary repair between September 2004 and December 2013 was performed...
September 28, 2016: Annals of Thoracic Surgery
Keti Vitanova, Julie Cleuziou, Christian Schreiber, Thomas Günther, Jelena Pabst von Ohain, Jürgen Hörer, Rüdiger Lange
BACKGROUND: Primary repair is the preferred strategy for surgical treatment of complete atrioventricular septal defect combined with the tetralogy of Fallot. However, a staged approach may be preferable for very small or cyanotic infants. The long-term outcomes of infants undergoing staged vs primary repair were compared. METHODS: Data from 47 patients with complete atrioventricular septal defect combined with the tetralogy of Fallot who were operated on at our institution between 1974 and 2013 were reviewed...
September 27, 2016: Annals of Thoracic Surgery
Carine Pavy, Olivier Ghez
The association of complete atrial ventricular septal defect (cAVSD) with tetralogy of Fallot remains a complex malformation that involves both inlet and outlet components of the ventricles. The surgical treatment used to be, in the 1980s, a staged repair strategy due to the high mortality rate of first primary repairs (PRs). However, nowadays, PRs have better outcomes. Although double-patch procedures are widely performed, this article describes the single-patch approach for cAVSD repair with transatrial-transpulmonary repair of the Fallot component with preservation of the pulmonary valve...
2016: Multimedia Manual of Cardiothoracic Surgery: MMCTS
Rosanne C Schoonbeek, Satoshi Takebayashi, Chikashi Aoki, Toru Shimaoka, Matthew A Harris, Gregory L Fu, Timothy S Kim, Yoav Dori, Jeremy McGarvey, Harold Litt, Wobbe Bouma, Gerald Zsido, Andrew C Glatz, Jonathan J Rome, Robert C Gorman, Joseph H Gorman, Matthew J Gillespie
BACKGROUND: Pulmonary insufficiency is the nexus of late morbidity and mortality after transannular patch repair of tetralogy of Fallot. This study aimed to establish the feasibility of implantation of the novel Medtronic Harmony transcatheter pulmonary valve (hTPV) and to assess its effect on pulmonary insufficiency and ventricular function in an ovine model of chronic postoperative pulmonary insufficiency. METHODS AND RESULTS: Thirteen sheep underwent baseline cardiac magnetic resonance imaging, surgical pulmonary valvectomy, and transannular patch repair...
October 2016: Circulation. Cardiovascular Interventions
Chin Siang Ong, Sriram Shankar, James W L Yip, Edgar L W Tay, Lynette L S Teo, Swee Chye Quek
We report the case of a 23-year-old man who developed constrictive pericarditis within four months after pulmonary valve replacement and repair of partial anomalous pulmonary venous connection. He had previously undergone repair of tetralogy of Fallot in infancy. After an unsuccessful trial of medical management for persistent right heart failure, magnetic resonance imaging was done, which showed a thickened pericardium. He underwent a radical pericardiectomy with a good outcome. The case is presented to illustrate a less well-recognized cause of cardiac failure following congenital cardiac surgery, which may otherwise be attributed to the failure of surgery or residual complications...
September 19, 2016: World Journal for Pediatric & Congenital Heart Surgery
Dalin Tang, Pedro J Del Nido, Chun Yang, Heng Zuo, Xueying Huang, Rahul H Rathod, Vasu Gooty, Alexander Tang, Zheyang Wu, Kristen L Billiar, Tal Geva
BACKGROUND: Accurate calculation of ventricular stress and strain is critical for cardiovascular investigations. Sarcomere shortening in active contraction leads to change of ventricular zero-stress configurations during the cardiac cycle. A new model using different zero-load diastole and systole geometries was introduced to provide more accurate cardiac stress/strain calculations with potential to predict post pulmonary valve replacement (PVR) surgical outcome. METHODS: Cardiac magnetic resonance (CMR) data were obtained from 16 patients with repaired tetralogy of Fallot prior to and 6 months after pulmonary valve replacement (8 male, 8 female, mean age 34...
2016: PloS One
Nidhi Bhatia, Kamlesh Kumari, Shiv Soni
No abstract text is available yet for this article.
July 2016: Journal of Anaesthesiology, Clinical Pharmacology
Akihisa Furuta, Mitsugi Nagashima, Takeshi Hiramatsu, Goki Matsumura, Kenji Yamazaki
The unilateral absence of a proximal pulmonary artery (UAPPA) is rare and is most frequently accompanied by cardiovascular anomalies such as tetralogy of Fallot or septal defects. We report a patient with truncus arteriosus with UAPPA in which we performed a two-stage surgical repair. During the first palliative operation, a right modified Blalock-Taussig shunt was constructed to develop the hypoplastic right pulmonary artery. At 10 months, the patient underwent patch closure of a ventricular septal defect with integration of both pulmonary arteries, and reconstruction of the right ventricular outflow tract using a conduit...
September 9, 2016: Journal of Cardiac Surgery
Frank Edwin, Kow Entsua-Mensah, Lawrence A Sereboe, Mark M Tettey, Ernest A Aniteye, Martin M Tamatey, Innocent Adzamli, Nana Akyaa-Yao, Kofi B Gyan, Ernest Ofosu-Appiah, David Kotei
BACKGROUND: The outcome of children born with conotruncal heart defects may serve as an indication of the status of pediatric cardiac care in sub-Saharan Africa (SSA). This study was undertaken to determine the outcome of children born with conotruncal anomalies in SSA, regarding access to treatment and outcomes of surgical intervention. METHODS: From our institution in Ghana, we retrospectively analyzed the outcomes of surgery, in the two-year period from June 2013 to May 2015...
September 2016: World Journal for Pediatric & Congenital Heart Surgery
Yoshiyuki Maekawa, Yoshinori Miyahara, Ko Yoshizumi, Masaaki Kawada, Takaomi Minami, Tomoyuki Sato, Akiko Yokomizo, Kensuke Oka, Sadahiro Furui, Koichi Kataoka
A combination of tetralogy of Fallot( TOF) and total anomalous pulmonary venous return(TAPVR) is rare and results in chronic volume and pressure load of the right side of the heart and underfilling of the left heart. We report a successful 2-staged surgical correction of TOF associated with TAPVR and atrial septal defect. The patient was unsuitable for total primary intracardiac correction because the volume of the left ventricle was considered to be small. First, repair of anomalous pulmonary venous return and palliative right ventricle outflow tract reconstruction were simultaneously performed in 2 months of birth...
September 2016: Kyobu Geka. the Japanese Journal of Thoracic Surgery
Richard J Dobson, Ify Mordi, Mark H Danton, Niki L Walker, Hamish A Walker, Nikolaos Tzemos
OBJECTIVE: Myocardial fibrosis has been associated with poorer outcomes in tetralogy of Fallot, however only a handful of studies have assessed its significance in the current era. Our aim was to quantify the amount of late gadolinium enhancement in both the LV and RV in a contemporary cohort of adults with surgically repaired tetralogy of Fallot, and assess the relationship with adverse clinical outcomes. DESIGN: Single centre cohort study SETTING: National tertiary referral center Patients: One hundred fourteen patients with surgically repaired tetralogy of Fallot with median age 29...
August 24, 2016: Congenital Heart Disease
Khoa N Nguyen, Heather S Byrd, Jonathan M Tan
AIM: Caudal epidural anesthesia has been shown to reduce stress response and shorten the time to extubation in children after cardiac surgery. Combined with general anesthesia, regional anesthesia has been proven to be safe and efficacious in the pediatric population. It is not known, however, whether the use of caudal anesthesia actually reduces postoperative pain scores and decreases postoperative opioid use. METHODS: We retrospectively analyzed the charts of 199 children who underwent repair for atrial septal defect (ASD), ventricular septal defect (VSD), and Tetralogy of Fallot (TOF) at a major academic children's hospital between 2010 and 2013...
November 2016: Paediatric Anaesthesia
Linyuan Jing, Gregory J Wehner, Jonathan D Suever, Richard J Charnigo, Sudad Alhadad, Evan Stearns, Dimitri Mojsejenko, Christopher M Haggerty, Kelsey Hickey, Anne Marie Valente, Tal Geva, Andrew J Powell, Brandon K Fornwalt
BACKGROUND: Patients with repaired tetralogy of Fallot (rTOF) suffer from progressive ventricular dysfunction decades after their surgical repair. We hypothesized that measures of ventricular strain and dyssynchrony would predict deterioration of ventricular function in patients with rTOF. METHODS: A database search identified all patients at a single institution with rTOF who underwent cardiovascular magnetic resonance (CMR) at least twice, >6 months apart, without intervening surgical or catheter procedures...
2016: Journal of Cardiovascular Magnetic Resonance
Kamill Del Toro, Brian D Soriano, Sujatha Buddhe
BACKGROUND: Echocardiogram has limitations in effectively assessing right ventricular (RV) function in children post tetralogy of Fallot (TOF) repair. We evaluated the utility of speckle tracking echocardiography (STE)-based RV global longitudinal strain (GLS) for the assessment of RV systolic function. METHODS: All patients with repaired TOF who had both echocardiograms and cardiac MRI (CMR) within a 6-month interval were included. RV volumes and ejection fraction (EF) were obtained by CMRs...
August 20, 2016: Echocardiography
Cyndi Sosnowski, Thomas Matella, Louis Fogg, Michel Ilbawi, Hosakote Nagaraj, Clifford Kavinsky, Andrew R Wolf, Karim Diab, Massimo Caputo, Damien Kenny
Objective/Background Historically, the sole option for patients with a dysfunctional native right ventricular outflow tract (RVOT) requiring re-establishment of pulmonary competence has been surgical PVR. We sought to compare early outcomes of hybrid pulmonary valve replacement (PVR) combining surgical plication of the main pulmonary artery followed by transcatheter PVR, with a contemporary cohort of surgical PVR patients. Methods Retrospective chart analysis of all patients with a dilated native RVOT eligible for surgical PVR over 36 months was performed...
August 18, 2016: Catheterization and Cardiovascular Interventions
David Faraoni, Daniel Vo, Viviane G Nasr, James A DiNardo
BACKGROUND: Children with major and severe congenital heart disease (CHD) undergoing noncardiac surgery are at increased risk of mortality. The objective of this study was to identify the predictors for in-hospital mortality, and to develop a risk stratification score that could be used to help decision making and the development of perioperative management guidelines. METHODS: We included all children with major (eg, tetralogy of Fallot with wide open pulmonary insufficiency, hypoplastic left heart syndrome including stage 1 repair) or severe CHD (eg, children with uncorrected CHD, children with documented pulmonary hypertension, children with ventricular dysfunction requiring medications, or children listed for heart transplant) recorded in the 2012 and 2013 American College of Surgeons National Surgical Quality Improvement Program Pediatric databases in a derivation cohort, and those recorded in the 2014 database in a validation cohort...
October 2016: Anesthesia and Analgesia
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