Effect of transannular patching on outcome after repair of tetralogy of Fallot

Kirklin, James K.; Kirklin, John W.; Blackstone, Eugene H.; Milano, Aldo Domenico; Pacifico, Albert D.

doi:10.1016/0003-4975(89)90671-1

Cited by 153 publications

(85 citation statements)

References 11 publications

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“…It has also been emphasized that bifascicular block can progress to trifascicular or complete block and sudden death; 21 however, there were no such patients among the present subjects and also none in the recent report of Gatzoulis et al 2 Transannular or right ventricular outflow patch is a risk factor for late arrhythmias. 2,5 Kirklin et al reported that transannular repair was a factor for early mortality but not for late mortality, 22 implying that transannular patch itself is not a major factor for fatal arrhythmias. Our data support their view.…”

Section: Discussionmentioning

confidence: 99%

Arrhythmias Late After Repair of Tetralogy of Fallot-A Japanese Multicenter Study-

Nakazawa

Shinohara

Sasaki

et al. 2004

Circ J

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Section: Discussionmentioning

confidence: 99%

Arrhythmias Late After Repair of Tetralogy of Fallot-A Japanese Multicenter Study-

Nakazawa

Shinohara

Sasaki

et al. 2004

Circ J

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“…16) It has been reported that transannular patch caused an increase in pulmonary regurgitation, progressive distention of the right ventricle, increase in tricuspid regurgitation, dysfunction of both the right and left ventricles, ventricular arrhythmias, and even sudden death. [17][18][19][20] Ge and colleagues 21) reported that the mode of right ventricular outflow tract reconstruction -transannular patch was a major cause of right ventricular dysfunction. Transannular patch and the consequent postoperative pulmonary regurgitation and tricuspid valve regurgitation together with tricuspid annulus enlargement greatly reduced right ventricular systolic function.…”

Section: Discussionmentioning

confidence: 99%

Risk Factors for Late Right Ventricular Systolic Dysfunction in Pediatric Patients With Repaired Tetralogy of Fallot

Ji¹,

Mei²,

Wang³

et al. 2015

Int. Heart J.

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SummaryTo evaluate independent risk factors for late right ventricular systolic dysfunction after correction of Tetralogy of Fallot (TOF) in a single-centre, retrospective and observational clinical trial.Patients less than 3 years of age who underwent correction of TOF and subsequently routine clinical follow-up of more than 36 months were included in this study and were divided either into an experimental group (right ventricular systolic dysfunction) or a control group (normal right ventricular systolic function) according to the tricuspid annular peak systolic velocity (TAPSV) value measured by pulsed wave-tissue Doppler imaging (pulsed wave-TDI). The relevant data of all selected patients were investigated and analyzed.From January 2012 to December 2012, a total of 113 consecutive eligible patients were enrolled in this study and were divided either into an experimental group (n = 41) or control group (n = 72). Through univariate analysis and subsequent logistic regression, low preoperative arterial oxygen saturation (OR = 1.66, 95%CI 1.22-4.58, P = 0.0163), age less than 6 months at the time of surgery (OR = 3.45, 95%CI 1.87-9.17, P = 0.0021), and transannular patch (OR = 2.15, 95%CI 1.31-5.38, P = 0.0015) were 3 independent risk factors for late right ventricular systolic dysfunction after correction of TOF.This clinical trial suggested low preoperative arterial oxygen saturation was associated with late right ventricular systolic dysfunction after correction of TOF, and appropriate age at the time of surgery and selection of a proper surgical method to reconstruct the right ventricular outflow tract contributed to improving late right ventricular systolic function in pediatric patients with repaired TOF. (Int Heart J 2015; 56: 80-85)

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“…Different surgical maneuvers are performed to relieve the varying sites and severity of PS. It should be noted that studies which report good long-term outcome for patients following such corrective surgeries focus on the adaptive quality of the RV, in light of the impending PI (16,17). However, this is in direct contraindication to other studies which have demonstrated the deleterious effect of chronic PI on RV function (3)(4)(5)(6).…”

Section: Discussionmentioning

confidence: 99%

CMR assessment of right ventricular function in patients with combined pulmonary stenosis and insufficiency after correction of tetralogy of Fallot

et al. 2013

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Background: Tetralogy of Fallot (TOF) is one of the most common types of congenital heart disease and requires prompt surgical correction. Post-correction pulmonary insufficiency (PI) often ensues in adulthood. At times, the PI is accompanied by residual pulmonary stenosis (PS). Little is known regarding right ventricular (RV) function in the setting of combined PS and PI. Purpose: To compare cardiac magnetic resonance (CMR) parameters for the assessment of RV function between patients with combined pulmonary stenosis and pulmonary insufficiency (PSPI) and isolated PI following surgical repair of TOF. Material and Methods: Retrospective review of patients with comparable corrected TOF and similar PI was performed. Seventeen patients (median age, 24 years; range, 10-52 years) had combined PSPI and 30 patients (median age, 30 years; range, 6-70 years) had isolated PI. Cine magnetic resonance (MR) images (Philips Medical Systems, Best, The Netherlands) in the short-axis plane were used to calculate end-systolic, end-diastolic, and stroke volumes (RVESV, RVEDV, RVSV) and to measure RV wall thickness. Velocity-encoded cine MR images were used to measure pulmonary regurgitation fraction (PRF) by calculating the ratio of backward flow and total forward flow, obtained from the main pulmonary flow analysis. Peak pressure gradient across the pulmonary valve was obtained from spectral Doppler echocardiography. Results: RVEF was 51 AE 8% in the PSPI patients and 39 AE 11%, in the patients with isolated PI (P ¼ 0.001). Additionally, RV wall thickness was 5.2 AE 0.8 mm in the PSPI patients compared to 2.6 AE 0.9 mm in the isolated PI patients (P ¼ 0.001). RVESVi and RVEDVi were significantly lower (P < 0.05) in patients with combined PSPI (60 AE 21 mL/m 2 , 121 AE 35 mL/m 2 , respectively) compared to the patients with isolated PI (95 AE 48 mL/m 2 , 152 AE 61 mL/m 2 , respectively). Conclusion: RV function is preserved in patients with PSPI when compared to patients with PI following surgical repair of TOF.

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Effect of transannular patching on outcome after repair of tetralogy of Fallot

Cited by 153 publications

References 11 publications

Arrhythmias Late After Repair of Tetralogy of Fallot-A Japanese Multicenter Study-

Arrhythmias Late After Repair of Tetralogy of Fallot-A Japanese Multicenter Study-

Risk Factors for Late Right Ventricular Systolic Dysfunction in Pediatric Patients With Repaired Tetralogy of Fallot

CMR assessment of right ventricular function in patients with combined pulmonary stenosis and insufficiency after correction of tetralogy of Fallot

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