Echocardiographic Assessment after Surgical Repair of Tetralogy of Fallot

Abstract

Surgical correction of tetralogy of Fallot is still one of the most frequently performed intervention in pediatric cardiac surgery, and in many cases, it is far from being a complete and definitive correction. It is rather an excellent palliation that solves the problem of cyanosis, but predisposes the patients to medical and surgical complications during followup. The decision-making process regarding the treatment of late sequel is among the most discussed topics in adult congenital cardiology. In post-operative Fallot patients, echocardiography is used as the first method of diagnostic imaging and currently allows both a qualitative observation of the anatomical alterations and a detailed quantification of right ventricular volumes and function, of the right ventricular outflow tract, and of the pulmonary valve and pulmonary arteries.The literature introduced many quantitative echocardiographic criteria useful for the understanding of the pathophysiological mechanisms involving the right ventricle and those have made much more objective any decision-making processes.

Echocardiographic predictors of elevated left ventricular end diastolic pressure in adolescent and adult patients with repaired tetralogy of Fallot

“…Routine congenital echocardiographic assessment of patients with repaired tetralogy of Fallot often focuses primarily on the right heart and ventricular function with little attention paid to the left atrium. 12,13 Qualitative assessment of left atrial enlargement may be flawed in this population as these estimates are often influenced by relative size to other heart structures. Patients with repaired tetralogy of Fallot frequently have a dilated right atrium as well as a dilated aortic root.…”

Modulating microRNAs in cardiac surgery patients: Novel therapeutic opportunities?

“…Secondly, tetralogy of Fallot (ToF) is the most common cyanotic congenital heart defect (Downing and Kim, 2015). While aspects of the physiology are now well appreciated by the congenital cardiac surgery community (Carminati et al, 2015), underlying mechanisms specific to the development of the disease require further elucidation. MiR research remains rather descriptive and only very few studies have tackled the genomic analysis of such CHD.…”

Echocardiographic assessment of pediatric semilunar valve disease

“…There are multiple studies of PR evaluation in patients after surgical correction of conotruncal defects; [56][57][58][59][60][61][62][63] however, they were done mostly in adults, [61][62][63] or mixed population of adults and children. 64 Few studies focused on the pediatric age group.…”

“…63 echocardiography-derived right ventricular volumes have superior correlation with MRI measurements. 56 It is also important to evaluate LV function, which may be influenced by right ventricular dilation and dysfunction. 57 Speckle tracking echocardiography in patients after tetralogy of Fallot repair showed that not only the RV free wall longitudinal strain and strain rate were decreased, but also the LV longitudinal strain.…”