Factors affecting biventricular function following surgical repair of tetralogy of fallot.

Sunakawa, Akio; Shirotani, Hitoshi; Yokoyama, Tatsuo; Oku, Hirosuke

doi:10.1253/jcj.52.401

Cited by 11 publications

(4 citation statements)

References 36 publications

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“…These include ventricular dysfunction, arrhythmias, and sudden death. 1,6,[10][11][12][13][14] Our study has shown that landmarks do exist to permit the surgeon to determine where in the septum, if necessary, incisions can be made and where sutures can be placed without damaging the first septal perforating artery.…”

Section: Discussionmentioning

confidence: 99%

The anatomy of the septal perforating arteries in normal and congenitally malformed hearts

Hosseinpour¹,

Anderson²,

Ho³

2001

The Journal of Thoracic and Cardiovascular Surgery

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Section: Discussionmentioning

confidence: 99%

The anatomy of the septal perforating arteries in normal and congenitally malformed hearts

Hosseinpour¹,

Anderson²,

Ho³

2001

The Journal of Thoracic and Cardiovascular Surgery

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“…Regarding pulmonary stenosis, it has long been known, anecdotally, that a combination of severe distal pulmonary artery stenosis and a transannular patch leads to early RV dilation and failure. 5 RV pressure-volume relationships show a linear increase in pulmonary regurgitant volume as RV afterload increases. 6 Our analysis showed a significant relationship between branch pulmonary artery stenosis defined by performing a concomitant arterioplasty at the time of pulmonary valve replacement and a shorter interval to pulmonary valve replacement.…”

Section: Risk Factorsmentioning

confidence: 98%

Risk factors for early pulmonary valve replacement after valve disruption in congenital pulmonary stenosis and tetralogy of Fallot

Kogon

Plattner

Kirshbom

et al. 2009

The Journal of Thoracic and Cardiovascular Surgery

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Male sex appears to shorten the interval between pulmonary valve disruption and pulmonary valve replacement, whereas small branch pulmonary artery diameter appears to lengthen the interval. Knowing which factors are detrimental and which are protective might help identify patients who are prone to a more rapid progression of right heart failure from free pulmonary insufficiency, possibly steering them toward more frequent follow-up or more aggressive heart failure medical regimens.

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“…It has been well established that patients with PI and increased afterload develop early right ventricular failure [16-18]. Furthermore, Chaturvedi and colleagues demonstrated a linear relationship between right ventricular afterload and the magnitude of PI in patients undergoing balloon valvuloplasty of distal stenosis [19].…”

Section: Discussionmentioning

confidence: 99%

PINOT NOIR: Pulmonic INsufficiency imprOvemenT with Nitric Oxide Inhalational Response

Hart

Devendra

Kim

et al. 2013

Journal of Cardiovascular Magnetic Resonance

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BackgroundTetralogy of Fallot (TOF) repair and pulmonary valvotomy for pulmonary stenosis (PS) lead to progressive pulmonary insufficiency (PI), right ventricular enlargement and dysfunction. This study assessed whether pulmonary regurgitant fraction measured by cardiovascular magnetic resonance (CMR) could be reduced with inhaled nitric oxide (iNO).MethodsPatients with at least moderate PI by echocardiography undergoing clinically indicated CMR were prospectively enrolled. Patients with residual hemodynamic lesions were excluded. Ventricular volume and blood flow sequences were obtained at baseline and during administration of 40 ppm iNO.ResultsSixteen patients (11 with repaired TOF and 5 with repaired PS) completed the protocol with adequate data for analysis. The median age [range] was 35 [19–46] years, BMI was 26 ± 5 kg/m2 (mean ± SD), 50% were women and 75% were in NYHA class I. Right ventricular end diastolic volume index for the cohort was 157 ± 33 mL/m2, end systolic volume index was 93 ± 20 mL/m2 and right ventricular ejection fraction was 40 ± 6%. Baseline pulmonary regurgitant volume was 45 ± 25 mL/beat and regurgitant fraction was 35 ± 16%. During administration of iNO, regurgitant volume was reduced by an average of 6 ± 9% (p=0.01) and regurgitant fraction was reduced by an average of 5 ± 8% (p=0.02). No significant changes were observed in ventricular indices for either the left or right ventricle.ConclusioniNO was successfully administered during CMR acquisition and appears to reduce regurgitant fraction in patients with at least moderate PI suggesting a potential role for selective pulmonary vasodilator therapy in these patients.Trials registrationClinicalTrials.gov, NCT00543933

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Factors affecting biventricular function following surgical repair of tetralogy of fallot.

Cited by 11 publications

References 36 publications

The anatomy of the septal perforating arteries in normal and congenitally malformed hearts

The anatomy of the septal perforating arteries in normal and congenitally malformed hearts

Risk factors for early pulmonary valve replacement after valve disruption in congenital pulmonary stenosis and tetralogy of Fallot

PINOT NOIR: Pulmonic INsufficiency imprOvemenT with Nitric Oxide Inhalational Response

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