Arterial haemodynamics in patients after repair of tetralogy of Fallot: influence on left ventricular after load and aortic dilatation

Abstract

These results indicating abnormal arterial haemodynamics after TOF repair highlight the importance of regular monitoring of the systemic arterial bed and potentially relevant cardiovascular events in long-term follow-up of TOF.

Aortic Root Dilatation and Aortic Stiffness in Patients With Single Ventricular Circulation

“…5,6,19 Indeed, a number of studies have reported increased aortic stiffness and its significant effect on aortic dilatation in these diseases. [7][8][9][10][11][12] In agreement with these previous observations, the present study adds new data showing that aortic medial pathology may also be implicated in the mechanism of aortic dilatation observed in patients with SiV physiology. The increased aortic stiffness observed in the present SiV patients is consistent with data from an important study by Niwa et al, who showed that abnormal aortic medial histopathology, characterized by elastic fiber disruption, was observed in patients with SiV physiology analogous to that of the present patients, including double-outlet right ventricle, single ventricle, or tricuspid atresia.…”

Relation of Aortic Stiffness and Strain by Cardiovascular Magnetic Resonance Imaging to Age in Repaired Tetralogy of Fallot

“…This is consistent with clinical data showing that direct measurements of PWV in children with TOF are worse compared with age-matched controls. 8,12 Other possible risk factors for aortic pathology may be more modifiable such as age at repair. Historically, the surgical approach in most centers often included an initial palliative shunt; definitive repair was performed later than in contemporary practice.…”

Noninvasive assessment of left ventricular contractility in pediatric patients using the maximum rate of pressure rise in peripheral arteries

“…In addition to Z c , arterial wave reflection is also a major determinant of the aortic pressure waveform, and short stature in infants may cause an early return of the reflected wave, which may augment the forward pressure wave [19]. However, younger age is associated with a compliant aortic wall, and this reduces pulse wave velocity [20,21], counteracting the effects of the short traveling pathway (distance between aorta and peripheral artery). Indeed, we did not observe any inflection point on the rapid upstroke of aortic pressure trajectory in any of the studied patients (as shown in Fig.…”