Diastolic dysfunction: a new additional criterion for optimal timing of pulmonary valve replacement in adult patient with tetralogy of Fallot?

Impact of restrictive physiology on intrinsic diastolic right ventricular function and lusitropy in children and adolescents after repair of tetralogy of Fallot

“…Diastolic dysfunction is also well described in these patients, potentially preceding systolic functional impairment 5. A proportion of repaired ToF patients shows restriction to diastolic RV filling indicated by antegrade diastolic forward flow in the pulmonary artery 6.…”

Echocardiographic assessment of pediatric semilunar valve disease

“…There are multiple studies of PR evaluation in patients after surgical correction of conotruncal defects; [56][57][58][59][60][61][62][63] however, they were done mostly in adults, [61][62][63] or mixed population of adults and children. 64 Few studies focused on the pediatric age group.…”

“…[61][62][63]66 Others have evaluated echocardiographic parameters of the right ventricle and their agreement with volumes and function estimated by MRI. 57 There is an increasing interest in functional assessment 59,61 including strain imaging 84-87 that may add complimentary information and reveal subclinical disease.…”

Transcatheter pulmonary valve insertion: when, how, and why

“…For many others, late right ventricular outflow tract dysfunction often leads to right ventricular dilation, hypertention, or dysfunction, which necessitates repeat surgical intervention usually involving surgical pulmonary valve replacement. [2][3][4][5] For patients with an early need for an right ventricle to pulmonary artery conduit, the need for repeat surgical intervention years down the road is a given, and deliberately oversizing conduits does not add to their clinical longevity. 6 It is for this combination of reasons that congenital interventionalists sought methods to extend conduit life and thereby widen the interval between surgeries.…”