Need of transannular patch in tetralogy of Fallot surgery carries a higher risk of reoperation but has no impact on late survival: results of Fallot repair in Finland

Ylitalo, Pekka; Nieminen, Heta; Pitkänen, Olli; Jokinen, Eero; Sairanen, Heikki

doi:10.1093/ejcts/ezu401

Cited by 45 publications

(48 citation statements)

References 18 publications

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“…Furthermore, we The overall survival after reparative TOF surgery reported in recent series is encouraging. 9,10,12,13 Though the data emerging from our population-based study is overall positive, our patients' survival appears to be somewhat lower than that reported in two recent European studies with follow-up in excess of 40 years. Among our TOF patients that survived reparative surgery, estimated cumulative survival was 100% at 10 years and 98.6% at 20 years, going down to 88.2% at 30 years and 77.5% at 40 years.…”

Section: Discussioncontrasting

confidence: 51%

“…The long-term outcomes of TOF repair have been reported by several institutions, from as early as the late 1970s. 2,3,[9][10][11][12][13] Most studies report experiences from a single or, at most, a few centers from the same country. In the last years, multicenter collaborations have created registries for patients with repaired TOF, in an attempt to generate larger cohorts and more robust data.…”

Section: Discussionmentioning

confidence: 99%

“…In our literature search, we found only one previous population-based outcome study in repaired TOF, conducted in Finland. 10 The increasing access to transthoracic echocardiography, which locally became available in the mid-1980s, and advances in cardiac surgery resulted in a move toward earlier diagnosis and surgical repair of TOF. 16,17 A shift toward earlier diagnosis of TOF and other CHD in Malta has already been reported.…”

Section: Discussionmentioning

confidence: 99%

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A first population-based long-term outcome study in adults with repaired tetralogy of Fallot in Malta

Caruana

Grech

2016

Congenital Heart Disease

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Section: Discussioncontrasting

confidence: 51%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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A first population-based long-term outcome study in adults with repaired tetralogy of Fallot in Malta

Caruana

Grech

2016

Congenital Heart Disease

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“…It carries a higher risk of reoperation, but has no impact on late survival [10] . We applied TAP in a comparatively high number of patients.…”

Section: Discussionmentioning

confidence: 99%

Surgery for Tetralogy of Fallot in Adults: Early Outcomes

Khan¹,

Tufail²,

Afridi³

et al. 2016

Brazilian Journal of Cardiovascular Surgery

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ObjectiveTo study the in-hospital outcome of adult patients who had undergone surgical repair for Tetralogy of Fallot.MethodsA retrospective descriptive study was conducted at the Punjab Institute of Cardiology searching the hospital records. All those adult patients who had undergone repair for Tetralogy of Fallot from January 2012 to December 2014 were included in the study. All the patients were operated by the same surgical team. Patients who underwent primary repair as well as those with previous palliative procedures were included in the study. Thirty days outcome was studied by recording variables from the database. Data was analysed using Statistical Package for Social Sciences version 16.ResultsA total of 80 patients was included in the study, in which there were 48 (60%) male patients and 32 (40%) female patients. Mean age was 21±0.21 years. Those with previous palliation were 15 (18.75%). The associated problems observed were: atrial septal defect 27 (33.75%), right aortic arch 30 (37.5%), patent ductus arteriosus 6 (7.5%) and double outlet right ventricle 3 (3.75%). In-hospital mortality recorded was 7 (8%). Postoperative complications encountered were low cardiac output syndrome 9 (11.25%), pleural effusion requiring tapping 3 (3.75%), reoperation for bleeding 3 (3.8%), pulmonary regurgitation (moderate to severe) 20 (25%) which occurred in the transannular patch group only and atrial arrhythmia 4 (5%).ConclusionA large number of adult patients are still operated for tetralogy of Fallot in Pakistan. With increasing experience in the technique the mortality and morbidity is comparable to international literature.

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“…While the vast majority of patients after repair for Tetralogy of Fallot (TOF) survive well into their adult years [1], there is progressive decline not only in right ventricular (RV), but also in left ventricular (LV) function [2]. Even though TOF is primarily a ‘right-sided’ heart disease, LV dysfunction is well recognized and predicts adverse outcomes after TOF repair [3, 4].…”

Section: Introductionmentioning

confidence: 99%

Increased left ventricular myocardial extracellular volume is associated with longer cardiopulmonary bypass times, biventricular enlargement and reduced exercise tolerance in children after repair of Tetralogy of Fallot

Riesenkampff

Luining

Seed

et al. 2016

Journal of Cardiovascular Magnetic Resonance

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BackgroundUnfavorable left ventricular (LV) remodelling may be associated with adverse outcomes after Tetralogy of Fallot (TOF) repair. We sought to assess T1 cardiovascular magnetic resonance (CMR) markers of diffuse LV myocardial fibrosis in children after TOF repair, and associated factors.MethodsIn this prospective, cross-sectional study, native (=non-contrast) T1 times and extracellular volume fraction (ECV) were quantified in the LV myocardium using CMR. Results were related to ventricular volumes and function, degree of pulmonary regurgitation, as well as surgical characteristics, and exercise capacity.ResultsThere was no difference in native T1 times or ECV between 31 TOF patients (age at CMR 13.9 ± 2.4 years, 19 male) and 15 controls (age at CMR 13.4 ± 2.6 years, 7 male). Female TOF patients had higher ECVs than males (25.2 ± 2.9 % versus 22.7 ± 3.3 %, p < 0.05). In the patient group, higher native T1 and ECV correlated with higher Z-Scores of right and left ventricular end-diastolic volumes, but not with reduced left and right ventricular ejection fraction or higher pulmonary regurgitation fraction. Longer cardiopulmonary bypass and aortic cross clamp times at surgery correlated with increased native T1 times and ECVs (r = 0.48, p < 0.05 and r = 0.65, p < 0.01, respectively). Maximum workload (percent of predicted for normal) correlated inversely with ECV (r = -0.62, p < 0.05). Higher native T1 times correlated with worse LV longitudinal (r = 0.50, p < 0.05) and mid short axis circumferential strain (r = 0.38, p < 0.05).ConclusionsAs compared to controls, TOF patients did not express higher markers of diffuse fibrosis. Longer cardiopulmonary bypass and aortic cross clamp times at surgery as well as biventricular enlargement and reduced exercise tolerance are associated with markers of diffuse myocardial fibrosis after TOF repair. Female patients have higher markers of diffuse myocardial fibrosis than males.

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Need of transannular patch in tetralogy of Fallot surgery carries a higher risk of reoperation but has no impact on late survival: results of Fallot repair in Finland

Cited by 45 publications

References 18 publications

A first population-based long-term outcome study in adults with repaired tetralogy of Fallot in Malta

A first population-based long-term outcome study in adults with repaired tetralogy of Fallot in Malta

Surgery for Tetralogy of Fallot in Adults: Early Outcomes

Increased left ventricular myocardial extracellular volume is associated with longer cardiopulmonary bypass times, biventricular enlargement and reduced exercise tolerance in children after repair of Tetralogy of Fallot

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