Pulmonary and ventricular functions in children with repaired tetralogy of Fallot

Demirpençe, Savaş; Güven, Barış; Yılmazer, Murat Muhtar; Öner, Taliha; Doksöz, Önder; Özdemir, Rahmi; Nacaroğlu, Hikmet Tekin; Meşe, Timur; Tavli, Vedide; Can, Demet

doi:10.5543/tkda.2015.52498

Cited by 5 publications

(11 citation statements)

References 20 publications

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“…Residuals and arrythmias might be other factors that contribute to the exercise limitation although it was not the case in our patients. Our results are in accordance with other authors who found that the exercise capacity in all patients was less than the minimum for age (20). However, it was contradictory to that reported by Kotby et al, who showed that the exercise performance was insignificantly reduced in patients in relation to the control group, probably because they used a different method to assess the exercise performance (the treadmill exercise stress test) (21).…”

Section: Discussionsupporting

confidence: 86%

“…The relation of exercise intolerance and right ventricle diastolic dysfunction is inconsistent, where some have reported that the diastolic dysfunction was responsible for the exercise limitation (20) and others (21,23) including our work did not. This inconsistency might be related to the different right ventricle assessment methods, or how the exercise intolerance was assessed.…”

Section: Discussioncontrasting

confidence: 50%

“…This continuous dilatation and stretch in RV may not manifest clinically in most TOF patients. Nonetheless, most TOF individuals report an acceptable level of exercise ability as a result of long-term adaptation (20). This explains the need to perform accurate measurements for the patients' exercise capacity.…”

Section: Discussionmentioning

confidence: 99%

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Exercise Limitation in Children after Tetralogy of Fallot Repair Is Not related to Right Ventricular Dysfunction: Single Egyptian Center Experience

Ibrahim

Mostafa

Ahmed

et al. 2022

Pediatric Sciences Journal

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Background: Tetralogy of Fallot (TOF) is one of the most prevalent cyanotic congenital heart diseases requiring surgery early in life. Aim of work: Exercise capacity and right ventricular diastolic dysfunction in children after TOF repair. Methods: Cross sectional descriptive study was conducted on 27 cases with TOF after total surgical repair. Cases were subjected to 12 leads ECG, chest X-ray, 6-minute walking test (6MWT) to assess the exercise capacity and transthoracic color Doppler echocardiography with assessment of right ventricle myocardial performance index (RVMPI) and pulmonary regurgitation index (PRi). Results: The mean ± SD age of the our studied was TOF patients 6.59 ± 1.80 years. The mean ± SD age at operation was 2.46 ± 0.95 years. All had dilated right ventricle (right ventricle dilatation index RVDi > 0.5), and moderate to severe pulmonary regurge (PR) estimated by PRi (PRi <0.77). Impaired RVMPI (>0.32) was found in 6 (22%) patients. Exercise capacity measured by 6-MWT was significantly reduced compared to the normal population of the same age group (p= 0.001). Results of 6-MWT did not correlate with the RVMPI (p= 0.44, r= -0.077), the PRi (p= 0.83, r=0.006), QRS (p=0.31, r=0.066), or corrected QT interval (p=0.89, r= 0.169). Conclusion: Exercise capacity was limited in our TOF patients after surgical repair, that was not related to right ventricular diastolic dysfunction as it did not correlate with RVMPI, degree of PR, QRS duration, nor corrected QT interval.

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Section: Discussionsupporting

confidence: 86%

Section: Discussioncontrasting

confidence: 50%

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Exercise Limitation in Children after Tetralogy of Fallot Repair Is Not related to Right Ventricular Dysfunction: Single Egyptian Center Experience

Ibrahim

Mostafa

Ahmed

et al. 2022

Pediatric Sciences Journal

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“…Therefore, long-term follow-up of patients is important. Our result is not very different from that found in the 2015 study by Demirpençe et al, 19 who followed 23 patients undergoing total correction surgery for 5.1 ± 3.5 years and observed that the time between palliative surgery and total correction was 4.3 ± 2.0 years and that pulmonary dysfunctions appeared approximately 6.3 ± 3.0 years after total correction. A 10-year multicenter study evaluating arrhythmia and sudden death in 795 patients who underwent complete correction of tetralogy of Fallot concluded that the lesions that predominantly influenced sudden death were ventricular tachycardia and pulmonary regurgitation.…”

Section: Discussioncontrasting

confidence: 59%

Predicting Factors of Surgical Mortality in Children and Adolescents Undergoing Correction of Tetralogy of Fallot

Pinheiro¹,

Azevedo²,

Rocha³

2022

International Journal of Cardiovascular Sciences

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Tetralogy of Fallot is the most common cyanotic congenital disease, with an incidence of 3 cases for every 10,000 live births, and it is responsible for approximately 5% to 7% of all congenital heart diseases. 1 For every 3,600 births, 1 child has the disease, corresponding to 3.5% of cases of congenital heart disease. 2 Congenital heart diseases can be classified as acyanotic or cyanotic. In cyanotic heart diseases, blood from the systemic venous return passes directly from the right to the left heart without passing through the pulmonary circulation, resulting in unsaturation of systemic arterial blood and central cyanosis. 3 Studies have demonstrated a strong association between morbidity in the intensive care unit and intraoperative factors, such as cardiopulmonary bypass time and anoxia time, in addition to the surgical techniques employed. 4 Among the signs and symptoms that can be identified in children with congenital heart disease who are hospitalized

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“…Abnormal pulmonary function has been previously described in cohorts with tetralogy of Fallot. [16][17][18] The mechanism for the abnormal pulmonary function after surgical repair is not well understood, but it likely involves a combination of developmental, mechanical, and functional factors affecting both the pulmonary vasculature and lung parenchyma. As alveolar growth begins in the last trimester and continues for the first several years of life, disruption of vascular development during this time could inhibit alveolar growth.…”

Section: Discussionmentioning

confidence: 99%

Pulmonary effects on exercise testing in tetralogy of Fallot patients repaired with a transannular patch

et al. 2018

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BackgroundA transannular patch is often used in the contemporary surgical repair of tetralogy of Fallot. This can lead to significant pulmonary insufficiency and increased right ventricular volumes and ultimately pulmonary valve replacement. Cardiopulmonary exercise testing is used to assess exercise capacity in tetralogy of Fallot patients before pulmonary valve replacement. There is only few published literatures on how lung function affects functional capacity in tetralogy of Fallot patients repaired with a transannular patch.MethodsA retrospective chart review was done from 2015 to 2017 on patients with tetralogy of Fallot who underwent maximal effort cardiopulmonary exercise testing with cycle ergometry and with concurrent pulmonary function testing. Tetralogy of Fallot patients repaired with a transannular patch without pulmonary valve replacement were compared with age, gender, and size-matched normal controls.ResultsIn the tetralogy of Fallot group, 24 out of 57 patients underwent primary repair with a transannular patch. When compared to the normal controls, they demonstrated abnormal predicted forced expiratory volume in one second (79 ± 23.1% versus 90.7 ± 14.1%, p<0.05), predicted maximal voluntary ventilation (74 ± 18% versus 90.5 ± 16.2%, p<0.05) while having low-normal predicted forced vital capacity (80.5 ± 17.2% versus 90.2 ± 12.4%, p<0.05) and normal breathing reserve percentage (50.3 ± 11.3% versus 47.5 ± 17.3%, p = 0.52). Cardiopulmonary exercise testing abnormalities included significantly lower percent predicted oxygen consumption (63.2 ± 12.2% versus 87 ± 12.1%, p<0.05), maximal heart rate (171.8 ± 18.9 versus 184.6 ± 13.6, p<0.05), and percent predicted maximum workload (61.7 ± 15.9% versus 88.3 ± 21.5%, p<0.05).ConclusionsTetralogy of Fallot patients repaired with a transannular patch can have abnormal pulmonary function testing with poor exercise capacity in addition to chronotropic incompetence and impaired muscular power.

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Pulmonary and ventricular functions in children with repaired tetralogy of Fallot

Abstract: The children with repaired TOF had impaired ventricular and pulmonary functions. Hence, right ventricular MPI along with FEV1, FVC and 6MWT distance may be useful in the follow-up of children with repaired TOF.

Cited by 5 publications

References 20 publications

Exercise Limitation in Children after Tetralogy of Fallot Repair Is Not related to Right Ventricular Dysfunction: Single Egyptian Center Experience

Exercise Limitation in Children after Tetralogy of Fallot Repair Is Not related to Right Ventricular Dysfunction: Single Egyptian Center Experience

Predicting Factors of Surgical Mortality in Children and Adolescents Undergoing Correction of Tetralogy of Fallot

Pulmonary effects on exercise testing in tetralogy of Fallot patients repaired with a transannular patch

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