Long-term results of correction of tetralogy of Fallot in adulthood

Atik, Fernando Antibas; Atik, Edmar; Cunha, Claúdio Ribeiro da; Canêo, Luiz Fernando; Assad, Renato S.; Jatene, Marcelo Biscegli; Riso, Arlindo; Barbero-Marcial, Miguel

doi:10.1016/j.ejcts.2003.11.002

Cited by 63 publications

(67 citation statements)

References 22 publications

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“…When a complete repair is anatomically and physiologically possible, correction of the defect provides the patient with a vastly superior quality of life, although the surgery carries somewhat higher mortality and morbidity in the adult than in the child. 17 Palliative procedures such as aorta-to-pulmonary artery shunts and transcatheter balloon dilation of the RV outflow tract may improve arterial saturation and reduce symptoms as a result; however, experience with these palliations is principally in children. Acute increases in pulmonary blood flow correspondingly increase pulmonary venous return, which places an acute volume load on the LV.…”

Section: Indications For Interventionmentioning

confidence: 99%

Pathophysiology of Congenital Heart Disease in the Adult

2008

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Section: Indications For Interventionmentioning

confidence: 99%

Pathophysiology of Congenital Heart Disease in the Adult

2008

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“…[1][2][3][4][5][6] However, in this case, we tried to prevent the slightest pulmonary regurgitation because the patient's right ventricle had suffered from pressure load and cyanosis for 55 years. Therefore, we decided to use a bioprosthetic valved conduit for right ventricular outfl ow tract reconstruction even though there was no abnormality in the course of his coronary arteries.…”

Section: Discussionmentioning

confidence: 99%

Correction of tetralogy of Fallot in an adult using a stented bioprosthetic valved conduit

Kiyokawa

Goh

Akasaka

et al. 2011

Gen Thorac Cardiovasc Surg

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A 55-year-old man with tetralogy of Fallot successfully underwent correction using a valved conduit. He was diagnosed as having congenital heart disease during childhood, but no surgical intervention was performed. Cyanosis and dyspnea on effort had progressed gradually. Catheterization showed a left ventricular end diastolic volume of 126 ml, and the pulmonary arteries had suffi cient diameters. To prevent postoperative pulmonary regurgitation, we planned to use a bioprosthetic valved conduit for right ventricular outfl ow tract reconstruction. At 4.5 years after the operation he is in New York Heart Association functional class I. The catheterization performed 1.5 years after the surgery showed no pressure gradient between the right ventricle and the pulmonary artery. Thus, total correction of tetralogy of Fallot in an adult can be achieved safely, and the use of a bioprosthetic stented valved conduit can be benefi cial.

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“…31,35,36 Recent studies have demonstrated that RV function is one of the most important predictors of survival and postoperative outcome in patients with CHD and RV pressure or volume overload. [31][32][33][34] In patients with repaired tetralogy of Fallot (TOF), severe pulmonary regurgitation is the most common cause of progressive RV dilation and failure and is associated with decreased exercise tolerance, atrial and ventricular arrhythmias, and sudden death. Severe RV dilation, especially when progressive, may be the first sign of a failing RV and should prompt consideration of pulmonary valve replacement.…”

Section: Measurement Of Rv Diastolic Diametermentioning

confidence: 99%