Perioperative echocardiography‐derived right ventricle function parameters and early outcomes after tetralogy of Fallot repair in mid‐childhood: a single‐center, prospective observational study

Raj, Ravi; Puri, Goverdhan Dutt; Jayant, Aveek; Thingnam, Shyam Kumar Singh; Singh, Ramandeep; Rohit, Manoj Kumar

doi:10.1111/echo.13333

Cited by 11 publications

(4 citation statements)

References 32 publications

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“…This compares favourably to the results of Raj. et al and Waqar et al, who reported moderate or severe pulmonary insufficiency postoperatively in 56% and 37.1% of their patients, respectively, even though the rates of TAP repair in their studies were very similar to ours [14,15].…”

Section: Discussionsupporting

confidence: 73%

“…Heinisch et al reported an exceedingly high rate of valve preservation in their cohort at 96%, which they attributed to unusually favourable pulmonary valve morphology and pulmonary annulus size in almost all of their patients [9]. In the other studies of complete repair of TOF in children older than one year of age, the rate of valve-preserving surgery was comparable to the rate in our study, ranging from 30% to 66.5% [8,[13][14][15]. The reported rate of valve preservation among children undergoing complete repair in infancy ranges from 22% to 80%, which is also comparable to our cohort [18][19][20][21].…”

Section: Discussionsupporting

confidence: 72%

“…[13]. A study by Raj et al showed an in-hospital mortality of 2%, with only one death among 50 children undergoing complete repair in a developing country at a median age of 6 years (range 1-14 years) [14]. Waqar et al reported on a large cohort of 307 children in a developing country with primary repair at a mean age of 9.6 ± 4.9 years.…”

Section: Discussionmentioning

confidence: 99%

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Contemporary early results of late repair of tetralogy of Fallot in children: a single-centre case series

Mottier

Prša

2021

Swiss Med Wkly

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AIMS: To describe the early results of complete repair of tetralogy of Fallot (TOF) in children older than one year of age.METHODS: We identified all patients older than one year of age who underwent TOF repair between 2007 and 2017. Data collected included type of surgical repair, survival at 30 days after surgery, reintervention within 30 days of surgery, length of stay in the intensive care unit (ICU), length of stay in hospital, and degree of residual right ventricular outflow tract (RVOT) stenosis and pulmonary insufficiency 30 days after surgery. RESULTS: 125 children (median age 4.4 years, interquartile range [IQR] 3-5.7) underwent complete repair of TOF, with pulmonary valve preservation in 66%, a transannular patch in 19%, and a valved right ventricular-to-pulmonary artery conduit in 15%. All patients survived. There were twelve (9.6%) reinterventions. Median ICU length of stay was 7 days and median hospital length of stay was 12 days. Significant residual RVOT stenosis was present in 7.2% and significant pulmonary insufficiency in 19.2%. Patients with a transannular patch had a significantly higher proportion of significant residual RVOT stenosis and significant pulmonary insufficiency compared with the other types of surgical repair. CONCLUSIONS: Compared with the existing literature on complete late repair of TOF in children, this study showed good early results with no mortality, similar rates of reintervention and valve-preserving surgery, higher ICU and hospital length of stay, higher incidence of significant residual RVOT stenosis, and lower incidence of significant pulmonary insufficiency. Repair with a transannular patch was a risk factor for significant residual RVOT stenosis and significant pulmonary insufficiency.

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Section: Discussionsupporting

confidence: 73%

Section: Discussionsupporting

confidence: 72%

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Contemporary early results of late repair of tetralogy of Fallot in children: a single-centre case series

Mottier

Prša

2021

Swiss Med Wkly

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“…Lower TAPSE has been reported in HIV+ young adults but not in HIV− controls . Follow‐up of all participants in our study may indicate if these findings are clinically relevant as both TAPSE and FAC are more useful in longitudinal studies .…”

Section: Discussionmentioning

confidence: 74%

Multisystem impairment in South African adolescents with Perinatally acquired HIV on antiretroviral therapy (ART)

et al. 2019

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Introduction Adolescents with perinatally acquired HIV ( PHIV ) are at risk of chronic disease due to long‐standing immune suppression, HIV disease and antiretroviral therapy ( ART ) exposure. However, there are few data on multisystem disease in this population. We investigated the overlapping burden of neurocognitive, cardiovascular, respiratory and/or renal impairment among PHIV positive ( PHIV +) adolescents. Methods In this cross‐sectional analysis, participants aged 9 to 14 years on ART for >6 months were recruited from seven sites across Cape Town from July 2013 through March 2015, together with age‐matched HIV‐negative ( HIV‐ ) adolescents. Impairment at enrolment was assessed across neurocognitive functioning (using the youth‐International HIV Dementia Scale); cardiac function (echocardiogram abnormality); respiratory function (abnormal spirometry) and renal function (abnormal glomerular filtration rate). Results and Discussion Overall, 384 PHIV + and 95 HIV‐ adolescents were included (mean age, 11.9 years; 49% female). Median age of ART initiation was 4.2 years ( IQR : 1.7 to 7.6) and median CD 4 count was 709 ( IQR : 556 to 944) with 302 (79%) of PHIV + adolescents virologically suppressed. Abacavir and Zidovudine were the most commonly used nucleoside reverse transcriptase inhibitors ( NRTI s) with 60% of adolescents on non‐nucleoside reverse transcriptase inhibitors ( NNRTI ) and 38% on a protease inhibitor ( PI ). Among PHIV + adolescents, 167 (43.5%) had single system impairment only, 110 (28.6%) had two systems involved, and 39 (10.2%) had three or four systems involved. PHIV + participants had more 2‐system and 3‐system impairment than HIV‐ , 110 (28.6%) versus 17 (17.9%), p = 0.03 and 39 (10.2%) versus 3 (4.3%), p = 0.03. PHIV + participants who had failed a year of school (73.8% vs. 46.4%, p = 0.00) and with a viral load >1000 copies/mL at enrolment (16.8% vs. 8.1%, p = 0.03) were more likely to have dual or multisystem impairment. Of those with cardiac impairment, 86.7% had an additional system impaired. Similarly, in those with neurocognitive impairment, almost 60% had additional systems impaired and of t...

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Assessing Right Ventricular Function in the Perioperative Setting, Part II

Vandenheuvel

Bouchez

Wouters

et al. 2019

Anesthesiology Clinics

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Perioperative echocardiography‐derived right ventricle function parameters and early outcomes after tetralogy of Fallot repair in mid‐childhood: a single‐center, prospective observational study

Abstract: Among the RV function parameters studied, RV FAC best predicted the early outcome variables after TOF repair, followed by TAPSE while lateral tricuspid annular velocity S' being the least predictive.

Cited by 11 publications

References 32 publications

Contemporary early results of late repair of tetralogy of Fallot in children: a single-centre case series

Contemporary early results of late repair of tetralogy of Fallot in children: a single-centre case series

Multisystem impairment in South African adolescents with Perinatally acquired HIV on antiretroviral therapy (ART)

Assessing Right Ventricular Function in the Perioperative Setting, Part II

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