scholarly journals “The Heart Sound Quintet”: A Case Report of Right-Sided Heart Failure Due to Free Pulmonary Regurgitation Long After Intracardiac Repair of Tetralogy of Fallot

2020 ◽  
Vol 21 ◽  
Author(s):  
Hiroshi Fujita ◽  
Kensuke Matsumoto ◽  
Keisuke Miwa ◽  
Makiko Suzuki ◽  
Makiko Suto ◽  
...  
Keyword(s):  
Heart Failure ◽  
Case Report ◽  
Tetralogy Of Fallot ◽  
Heart Sound ◽  
Pulmonary Regurgitation ◽  
Intracardiac Repair

scholarly journals Cardiac resynchronization therapy in a child with tetralogy of Fallot

2020 ◽  
Vol 30 (1) ◽  
pp. 73-77
Author(s):  
Horia Stefan Rosianu ◽  
Razvan Olimpiu Mada ◽  
Simona Oprita ◽  
Adrian Stef ◽  
Manuel Chira ◽  
...  
Keyword(s):  
Heart Failure ◽  
Cardiac Resynchronization Therapy ◽  
Tetralogy Of Fallot ◽  
Pediatric Population ◽  
Clinical Status ◽  
Pulmonary Regurgitation ◽  
Cardiac Resynchronization ◽  
Heart Team ◽  
Resynchronization Therapy ◽  
Permanent Pacing

Cardiac resynchronization therapy is a common option in adult patients with heart failure and conduction abnormalities. Specific selection criteria for pediatric population are lacking. We report the case of a 14-year-old boy with signifi cant pulmonary regurgitation subsequent to corrected tetralogy of Fallot and single chamber permanent pacing which presented with heart failure symptoms. Careful management was planned by a Heart Team including pediatric cardiologist, cardiac surgeon, interventional cardiologist and anesthesiologist. After undergoing cardiac surgery with complete correction of the pulmonary regurgitation and upgrade to a triple chamber pacing, the patient was discharged in good clinical status.

Abstract 17237: Overweight Associated With Advanced Biventricular Remodeling and Increased Morbidity in Adults With Repaired Tetralogy of Fallot

Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
Jonathan D Kochav ◽  
Brian Ghoshhajra ◽  
Doreen DeFaria Yeh ◽  
Sean Singer ◽  
Pedro V Staziaki ◽  
...  
Keyword(s):  
Heart Failure ◽  
At Risk ◽  
Tetralogy Of Fallot ◽  
Systolic Dysfunction ◽  
Pulmonary Regurgitation ◽  
Right Heart Failure ◽  
Pulmonary Valve Replacement ◽  
Normal Weight ◽  
End Diastolic Volume ◽  
Repaired Tetralogy Of Fallot

Background: Individuals with repaired tetralogy of Fallot (rTOF) often develop progressive pulmonary regurgitation (PR) and right ventricular (RV) dilation after initial repair, placing them at risk of arrhythmia, right heart failure, and sudden cardiac death. MRI research has led to body surface area (BSA)-indexed RV end-diastolic volume cutoffs (RVEDV>160ml/m2) for timing of pulmonary valve replacement (PVR), a strategy potentially limited by rising rates of obesity in this population. Hypothesis: Indexing RV volumes to actual BSA may underestimate disease progression in overweight patients. Methods: This retrospective analysis identified adults with rTOF and significant PR who underwent MRI for evaluation of RVEDV prior to consideration of PVR. Charts were reviewed for major adverse clinic events including death, heart failure, and sustained arrhythmia. Chamber volumes were indexed to BSA, as well as ideal BSA (defined by weight set to achieve BMI of 25). Results: 58 adults with rTOF who met inclusion criteria were identified; 43% were overweight (BMI>25). Compared with normal weight individuals, overweight patients were older at MRI (44±12 vs 30±10 years, p<0.001) and definitive repair (9±8 vs 3±3 years, p=0.002), and more likely to have staged repair (56% vs 24%, p=0.01). Overweight patients had more advanced RV (RVEF 40±11% vs 55±33%, p=0.03) and LV (LVEF 53±12% vs. 59±13%, p=0.02) systolic dysfunction, as well as larger LVEDV (84±26 vs 65±15ml/m2, p=0.001) and RVEDV (152±50 vs 139± 61ml/m2, p=0.37) when indexed to ideal BSA. Overweight patients had higher incidence of arrhythmia (58% vs 20%, p=0.04), and decompensated HF (15% vs 0%, p=0.06) prior to MRI. Indexing RVEDV to ideal BSA in the overweight population led to reclassification of 4 patients meeting criteria for PVR (15 vs 11, p<0.001) meeting established criteria for PVR (RVEDV>160ml/m2), 3/4 of whom had clinical arrhythmia prior to MRI. Conclusions: Overweight patients with rTOF not only demonstrate advanced biventricular remodeling, but also experience negative clinical outcomes. Indexing RV volume to actual BSA may underestimate chamber size, whereas indexing to ideal BSA may identify high risk patients at risk for cardiac outcomes who could benefit from PVR.

Tetralogy of Fallot With Interatrial Communication of the Inferior Sinus Venosus Type: A Rare Association Causing Post-Operative Desaturation

2019 ◽  
Vol 10 (6) ◽  
pp. 801-802
Author(s):  
Gaurav Agrawal ◽  
Anupam Das
Keyword(s):  
Case Report ◽  
Tetralogy Of Fallot ◽  
Sinus Venosus ◽  
Transthoracic Echocardiogram ◽  
Interatrial Communication ◽  
Postoperative Course ◽  
Rare Association ◽  
Intracardiac Repair ◽  
Sinus Venosus Defect ◽  
Inferior Sinus Venosus Defect

This case report describes a rare association of tetralogy of Fallot with interatrial communication of the inferior sinus venosus type (inferior sinus venosus defect). The patient underwent intracardiac repair for tetralogy of Fallot at 8 months of age. His postoperative course was complicated by desaturation. On reexploration, interatrial communication of the inferior sinus venosus type was revealed which went unnoticed on transthoracic echocardiogram as well as on computerized tomogram.

scholarly journals ‘Superimposed miracles’ An extremely rare case of a septuagenarian with an unrepaired tetralogy of Fallot: a case report

2021 ◽  
Author(s):  
Makiko Suzuki ◽  
Kensuke Matsumoto ◽  
Yu Izawa ◽  
Ken-Ichi Hirata
Keyword(s):  
Heart Failure ◽  
Tetralogy Of Fallot ◽  
Cardiopulmonary Arrest ◽  
Pulmonary Stenosis ◽  
Left Ventricular ◽  
Childhood And Adolescence ◽  
Term Survival ◽  
Intracardiac Repair ◽  
Number Of Patients ◽  
Ventricular Compliance

Abstract Background Although the life expectancy of patients with tetralogy of Fallot (TOF) is comparable to that of the general population due to advancements in surgical intervention, if untreated, patients with TOF may die during their childhood. However, it has been anecdotally reported that a small number of patients with unrepaired TOF survived into their senescence. Case Summary A 71-year-old man with a history of multiple heart failure admissions was referred to our institute after successful cardiopulmonary arrest resuscitation. Transthoracic echocardiography showed the overriding of the aorta on a large ventricular septal defect and right ventricular hypertrophy, along with severe pulmonary stenosis (PS), all of which indicated unrepaired TOF. Computed tomography revealed a patent Blalock-Taussig shunt, which was constructed at the age of 19 years. Coronary angiography revealed multivessel coronary stenoses. Although radical intracardiac repair was not performed due to his multiple comorbidities, his heart failure symptoms were significantly improved owing to proper medication titration. One year following discharge, the patient was well and enjoyed playing golf. Discussion Specific anatomical, functional and haemodynamic characteristics may be required for the long-term survival of patients with TOF. PS should be initially mild to guarantee pulmonary flow during childhood and adolescence, and gradual PS exacerbation should be paralleled with systemic-to-pulmonary collateral development or an extra-cardiac shunt. Moreover, reduced left ventricular compliance may act as a balancing factor against a right-to-left shunt. The presence of all of these special requirements may have contributed to the unusual survival for this patient.

Kết quả dài hạn sau phẫu thuật tứ chứng fallot tại Trung tâm Tim mạch - Bệnh viện Nhi Trung ương

2021 ◽  
Author(s):  
Thinh Truong Nguyen Ly
Keyword(s):  
Heart Failure ◽  
Tetralogy Of Fallot ◽  
Pulmonary Regurgitation ◽  
Long Term Results ◽  
Total Correction ◽  
Long Term Outcome ◽  
Late Mortality ◽  
Heart Center

Đặt vấn đề: Phẫu thuật sửa toàn bộ tứ chứng Fallot đã được tiến hành tại Việt Nam với kết quả ngắn hạn khả quan, tuy nhiên kết quả lâu dài sau phẫu thuật thì vẫn chưa được làm rõ. Nghiên cứu này của chúng tôi được tiến hành nhằm đánh giá kết quả dài hạn sau phẫu thuật sửa toàn bộ tứ chứng Fallot tại Trung tâm Tim mạch - Bệnh viện Nhi Trung ương. Đối tượng - phương pháp: Các bệnh nhân được phẫu thuật sửa toàn bộ tại Trung tâm Tim mạch - Bệnh viện Nhi Trung ương trong thời gian từ tháng 12 năm 2006 đến tháng 12 năm 2020 được thu thập bệnh án và được đưa vào nghiên cứu. Kết quả: Trong thời gian nghiên cứu, có tổng số 532 trường hợp được phẫu thuật sửa toàn bộ tứ chứng Fallot tại Trung tâm Tim mạch - Bệnh viện Nhi Trung ương. Tuổi phẫu thuật trung bình của các bệnh nhân trong nhóm nghiên cứu là 11.7 tháng (8.8 - 17.4). Trong nhóm nghiên cứu có 11 trường hợp tử vong sớm sau phẫu thuật (2.1%) và 2 trường hợp tử vong muộn sau phẫu thuật (0.4%). Tỷ lệ bệnh nhân cần mổ lại trong nhóm nghiên cứu là 2.3% (12 bệnh nhân). Thời gian theo dõi trung bình sau phẫu thuật là 40.4 ± 26.27 tháng. Triệu chứng suy tim trên lâm sàng theo Ross tại thời điểm khám lại cuối cùng cho thấy phần lớn các bệnh nhân không có biểu hiện suy tim trên lâm sàng, chỉ có duy nhất 1 bệnh nhân Ross - III. Kết quả siêu âm kiểm tra tại thời điểm khám lại cuối cùng cho thấy có: 144 bệnh nhân (27%) có hở van ĐMP tự do, 42 bệnh nhân (7.9%) hở phổi mức độ trung bình, có 90 bệnh nhân (16.9%) có tình trạng giãn thất phải sau mổ ở các mức độ, và 2 trường hợp hở van ba lá mức độ trung bình nặng. Kết quả kiểm tra điện tim cho thấy hình ảnh block nhánh phải chiếm tỷ lệ 54.2%; hình ảnh giãn thất phải chiếm tỷ lệ 68.2%, và 2.3% bệnh nhân có hình ảnh block nhĩ thất độ I. Kết luận: Kết quả lâu dài sau phẫu thuật sửa toàn bộ tứ chứng Fallot tại Trung tâm Tim mạch - Bệnh viện Nhi Trung ương là tốt. Theo dõi lâu dài sau phẫu thuật là cần thiết đối với nhóm bệnh tim bẩm sinh phức tạp này nhằm đánh giá nguy cơ tử vong muộn và các yếu tố liên quan tới mổ lại của bệnh nhân. ABSTRACT RESULTS OF TOTAL CORRECTION FOR TETRALOGY OF FALLOT IN CHILDREN HEART CENTER - NATIONAL CHILDREN’S HOSPITAL VIETNAM Objective: Long term results of treatment for total correction of tetralogy of Fallot is unknow in Vietnam. We conduct this study to evaluate the long - term results of surgical treatment for tetralogy of Fallot in Children Heart Center, National Children Hospital, Hanoi, Vietnam. Methods: A retrospective study was conducted to evaluate the long - term outcome after total correction for tetralogy of Fallot in Children Heart Center - National Children Hospital, Hanoi, Vietnam since December 2006 to December 2020. Results: There were 532 patients operated during the study period. The median patient age was 11.7months (8.8 - 17.4). The hospital mortality was 11 patients (2.1%), and the late mortality was 2 patients (0.4%). There were 12 patients required re - operation during follow up, with the median time of follow - up was 40.4 ± 26.27months. According to Ross classification about heart failure, the majority of the patient have no heart failure, and only 1 patient have Ross - III. The echocardiography at the last visit shows: 144 patients (27%) have free pulmonary regurgitation, 42 patients (7.9%) have moderate pulmonary regurgitation, and 90 patients (16.9%) have right ventricle enlargement, with 2 patients have severe tricuspid valve regurgitation. The electrocardiogram shows: right bundle block was 54.2%; right ventricular dilation was 68.2%, and 2.3% of the patient have first degree of atrioventricular block. Conclusion: Long term results of total correction for tetralogy of Fallot in Children Heart Center, National Children Hospital are good. Further investigation is needed to evaluate the late mortality and morbidity in this complex heart disease. Key words: Tetralogy of Fallot, total correction, long term results.

scholarly journals Aspergilloma after intracardiac repair of tetralogy of Fallot; a case report

1991 ◽  
Vol 5 (6) ◽  
pp. 653-658
Author(s):  
Yoshiaki Abe ◽  
Sumiho Kurisu ◽  
Kiyonori Komagata ◽  
Nobuo Ogawa ◽  
Makoto Yano ◽  
...  
Keyword(s):  
Case Report ◽  
Tetralogy Of Fallot ◽  
Intracardiac Repair
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