When is the Best Time for Corrective Surgery in Patients with Tetralogy of Fallot between 0 and 12 Months of Age?

Martins, Izabela F; Doles, Iara C; Bravo-Valenzuela, Nathalie Jeanne; Santos, Adriana de Oliveira Ribeiro Dos; Varella, Marcela S P

doi:10.21470/1678-9741-2018-0019

Cited by 18 publications

(19 citation statements)

References 33 publications

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“…The best age for performing definitive corrective surgery for ToF is still a topic of discussion but there is a world-wide tendency to perform Fallot corrections as early as six months [34]. In a previous study by Li et al [8] lower strain values of the RV were found in patients operated at an age above 12 months of age as compared to an age below 12 months.…”

Section: Relation To Clinical Parametersmentioning

confidence: 98%

Left and Right Ventricular Impairment Shortly After Correction of Tetralogy of Fallot

et al. 2020

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Surgical repair of Tetralogy of Fallot (ToF) is usually performed in the first months of life with low early postoperative mortality. During long-term follow-up, however, both right (RV) and left ventricular (LV) performances may deteriorate. Tissue Doppler imaging (TDI) and speckle tracking echocardiography (ST) can unmask a diminished RV and LV performance. The objective of the current study was to assess the cardiac performance before and shortly after corrective surgery in ToF patients using conventional, TDI and ST echocardiographic techniques. Thirty-six ToF patients after surgery were included. Transthoracic echocardiography including TDI and ST techniques was performed preoperatively and at hospital discharge after surgery (10 days to 4 weeks after surgery). Median age at surgery was 7.5 months [5.5–10.9]. Regarding the LV systolic function there was a significant decrease in interventricular septum (IVS) S′ at discharge as compared to preoperatively (pre IVS S′ = 5.4 ± 1.4; post IVS S′ = 3.9 ± 1.2; p < 0.001) and in global longitudinal peak strain (GLS) (pre = − 18.3 ± 3.4; post = − 14.2 ± 4.1; p = 0.003); but not in the fractional shortening (FS). Both conventional and TDI parameters showed a decrease in diastolic function at discharge. Tricuspid Annular Plane Systolic Excursion and RV S′ were significantly lower before discharge. When assessing the RV diastolic performance, only the TDI demonstrated a RV impairment. There was a negative correlation between age at surgery and postoperative LV GLS (R = − 0.41, p = 0.031). There seems to be an impairment in left and right ventricle performance at discharge after ToF corrective surgery compared to preoperatively. This is better determined with TDI and ST strain imaging than with conventional echocardiography.

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Section: Relation To Clinical Parametersmentioning

confidence: 98%

Left and Right Ventricular Impairment Shortly After Correction of Tetralogy of Fallot

et al. 2020

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“…Ao que tudo indica, ela tem leve prevalência no sexo feminino e sua causa ainda não é bem definida 2,7 . Consiste em uma série de alterações anatômicas que resultam em consequências tanto fisiológicas como patológicas 6,9 .…”

Section: Resultsunclassified

A Combinação Das Alterações Anatômicas Cardíacas Na Tetralogia De Fallot

MARCONATO

Fatuch

Seleme

et al. 2022

RMP

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RESUMO –A tetralogia de Fallot é a cardiopatia congênita cianótica mais comum. Caracteriza-se por tétrade de malformações anatômicas que incluem estenose pulmonar, defeito do septo ventricular, hipertrofia do ventrículo direito e dextroposição da aorta (cavalgamento da aorta). O objetivo deste estudo foi analisar e descrever as alterações anatômicas cardíacas, tratamento e prognóstico de pacientes com a doença. É revisão narrativa de artigos indexados na base de dados PubMed, Google Acadêmico e LILACS utilizando os descritores “tetralogy of Fallot”, “congenital heart disease”, “cyanotic disease”. Em conclusão, a tetralogia de Fallot é cardiopatia congênita comum e com prognóstico ruim caso não seja realizado diagnóstico e tratamento precoces. O seguimento médico contínuo e próximo ao paciente é importante para acompanhar a evolução e programar novas intervenções caso necessárias.

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“…Tetralogy of Fallot is one of the most prevalent cyanotic congenital heart diseases, presenting a poor prognosis without surgical treatment ( 4 ). Definitive corrective surgery is the best option for patients with ToF.…”

Section: Discussionmentioning

confidence: 99%

“…From a genetic perspective, the etiology of ToF is a combination of genetics and environment, with a familial recurrence risk of 3% ( 2 ). Without timely surgical treatment, only 10% of patients could survive beyond the age of 20, others die before adulthood due to the consequences of secondary myocardial hypertrophy and heart failure caused by chronic hypoxia ( 4 ). Primary repair in the 1st year of life is the most prevalent strategy, with definitive corrective surgery as the best approach ( 5 ).…”

Section: Introductionmentioning

confidence: 99%

Surgical Strategies for Preservation of Pulmonary Valve Function in a Radical Operation for Tetralogy of Fallot: A Systematic Review and Meta-Analysis

Wang

et al. 2022

Front. Cardiovasc. Med.

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ObjectiveTo evaluate the efficacy and safety of different surgical strategies to preserve pulmonary valve function. Surgical procedures evaluated include intraoperative balloon pulmonary valvuloplasty (IBPV), pulmonary valve reconstruction, and commissurotomy and pulmonary cusp augmentation (PCA) in patients who underwent a radical operation for Tetralogy of Fallot (ToF).Materials and MethodsThe five databases searched in the current study included the Cochrane Library, PubMed, China National Knowledge Infrastructure, VIP, and WanFang data. A systematic search for control trials was performed in each database from the start date of each database until December 2021. The Newcastle-Ottawa Scale (NOS) was used to evaluate the quality of included studies.ResultsA total of 15 retrospective studies with a total number of 1,396 participants were included in this study. In subgroup 1 (IBPV vs. TAP), patients undergoing IBPV had a less degree of regurgitation at 1–2 years after the surgery. The reintervention rate increased in the IBPV group at 5 years. In subgroup 2 (pulmonary valve reconstruction vs. TAP), the degree of regurgitation decreased in the pulmonary valve reconstruction group at 1 month after the surgery. In subgroup 3 (valve-sparing operation vs. TAP), the comparison demonstrated decreased rates for surgical mortality and reintervention at 5–10 years after the surgery.ConclusionWe proposed that pulmonary valve function in a radical operation for ToF was preserved. IBPV, pulmonary valve reconstruction, and commissurotomy and PCA can be performed during the surgical procedure based on the developmental status and anatomical characteristics of the right ventricular outflow tract (RVOT), pulmonary valve, and pulmonary artery.Systematic Review Registration[https://www.crd.york.ac.uk/prospero/], identifier [CRD42022300987].

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When is the Best Time for Corrective Surgery in Patients with Tetralogy of Fallot between 0 and 12 Months of Age?

Cited by 18 publications

References 33 publications

Left and Right Ventricular Impairment Shortly After Correction of Tetralogy of Fallot

Left and Right Ventricular Impairment Shortly After Correction of Tetralogy of Fallot

A Combinação Das Alterações Anatômicas Cardíacas Na Tetralogia De Fallot

Surgical Strategies for Preservation of Pulmonary Valve Function in a Radical Operation for Tetralogy of Fallot: A Systematic Review and Meta-Analysis

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