Right ventricular remodeling after conduit replacement in patients with corrected tetralogy of Fallot - evaluation by cardiac magnetic resonance

Guné, Henrik; Sjögren, Johan; Carlsson, Marcus; Gustafsson, Ronny; Sjöberg, Pia; Nozohoor, Shahab

doi:10.1186/s13019-019-0899-6

Cited by 10 publications

(5 citation statements)

References 30 publications

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“…In the same series, the RVEF did not change significantly after PVR (from 46% to 42%, P = .34). 31 The notion of RV size improvement with no significant improvement in function is also demonstrated in a meta-analysis by Mongeon et al, which reported a mean significant reduction of 61 mL/m 2 in indexed RVEDV after PVR but did not reveal any significant improvement in RVEF after PVR. 32…”

Section: Discussionmentioning

confidence: 83%

Long-Term Outcome Following Pulmonary Valve Replacement in Repaired Tetralogy of Fallot

Mosa

Madathil

Bernier

et al. 2021

World J Pediatr Congenit Heart Surg

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Background: Late pulmonary valve replacement following repair of tetralogy of Fallot may become necessary in patients with chronic pulmonary insufficiency. There is limited information on the long-term outcome of these prostheses, which is the focus of this study. Methods: We conducted a retrospective study of patients with repaired tetralogy of Fallot who underwent pulmonary valve replacement from 1990 to 2015 in our institution. We investigated imaging and clinical parameters including mortality and late adverse events (reintervention [surgical or transcatheter]), infective endocarditis, or arrhythmias requiring device implantation or ablation. Results: There were 69 patients divided into 3 groups: Carpentier-Edwards (n = 14), Contegra (n = 40), and pulmonary homograft (n = 15). The mean age at the time of pulmonary valve replacement was 21 ± 12 years. The mean follow-up was 8.5 ± 4.7 years. The mean preoperative and postoperative right ventricular end-diastolic volume index was 210 ± 42 and 120 ± 24 mL/m2, respectively. There were no mortalities. Late adverse events were observed in 23 (33%) patients: 15 (22%) reintervention (surgical or transcatheter), 11 (16%) endocarditis, and 11 (16%) arrhythmias. Overall, 1-, 5-, and 10-year freedom from surgical reintervention was 98.5%, 93.6%, and 79.3%, respectively. The Contegra group had significantly higher pulmonary valve gradients, a higher risk of developing late adverse events compared to Carpentier-Edwards ( P = .046) and pulmonary homograft ( P = .055) in multivariate analysis and increased risk for reintervention in the univariate analysis (hazard ratio: 3.4; 95% CI: 0.92-13; P value.066). Conclusion: Pulmonary valve replacement in patients with repaired tetralogy of Fallot has acceptable short- and intermediate-term outcomes. Contegra prosthesis had a higher risk of late adverse events with higher pulmonary valve gradients.

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Section: Discussionmentioning

confidence: 83%

Long-Term Outcome Following Pulmonary Valve Replacement in Repaired Tetralogy of Fallot

Mosa

Madathil

Bernier

et al. 2021

World J Pediatr Congenit Heart Surg

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“…Concerning functional data, the increase of LV EDVi and ESVi after PVR may be due to a decrease in the volume and pressure overload on the RV which is transmitted to the LV via the interventricular septum, effectively allowing the LV to improve its expansion [ 18 , 19 ]. Additionally, the decrease observed in RV EDVi, ESVi, and SV was an expected positive consequence of PVR, and the regression towards normal RV volumes may suggest in our cohort an adequate intervention timing [ 20 , 21 ].…”

Section: Discussionmentioning

confidence: 99%

The predictive role of right ventricular late gadolinium enhancement in patients with tetralogy of Fallot undergoing pulmonary valve replacement

et al. 2023

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Background Our purpose was to evaluate the correlations between right ventricular (RV) late gadolinium enhancement (LGE) at cardiac magnetic resonance (CMR) in patients with tetralogy of Fallot (ToF) scheduled for pulmonary valve replacement (PVR) and post-PVR functional data. Methods We retrospectively reviewed ToF patients scheduled for PVR who underwent two CMR examinations at our institution, one before the procedure (CMR-0), including contrast-enhanced sequences, and one after the procedure (CMR-1). Functional left and RV data were obtained by segmenting short-axis stacks on both CMR examinations, and normalised variations were calculated by dividing differences between CMR-1 and CMR-0 by the intercurring time interval, whereas the RV scar burden was assessed on CMR-0 LGE sequences both semiquantitatively and quantitatively. Data were reported as median and interquartile range, differences were appraised with the Mann–Whitney U test, while correlations were assessed with Spearman’s ρ. Results Fifteen patients with a median age of 25 years (16–29), including 9 (60%) males, with a median time interval between CMR-0 and CMR-1 of 17 months (12–23), were retrospectively reviewed. The semiquantitative LGE score at CMR-0 was 7 (6–9), and LGE volume was 4.49 mL (3.70–5.78), covering 5.63% (4.92–7.00) of the RV. RV LGE score showed a moderate positive correlation with the normalised variation of RV stroke volume (ρ = 0.662, p = 0.007) and a borderline moderate positive correlation with the normalised variation of RV end-diastolic indexed volume (ρ = 0.513, p = 0.050). Conclusions The assessment of RV LGE before PVR may provide insights on post-PVR functional data, potentially facilitating a patient-tailored treatment pathway.

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“…La reparación completa de la tetralogía de Fallot consiste en el cierre de la comunicación interventricular con un parche, la ampliación del tracto de salida del ventrículo derecho con resección muscular y valvuloplastia pulmonar, y un parche limitado a través del anillo pulmonar o el tronco pulmonar si es necesario. Esta se ha realizado exitosamente en las últimas décadas, con mortalidad inferior al 5% con mejoras sustanciales en la hemodinámica [14,15]; sin embargo, existen efectos adversos tardíos como insuficiencia progresiva ventricular derecha, arritmias y muerte súbita [12] que deben ser considerados y explicados al paciente y sus familiares.…”

Section: Discussionunclassified

Informe de caso y revisión bibliográfica: Tetralogía de Fallot

Heras

Rodríguez

2019

RFCM

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Tetralogy of Fallot is the most common cyanotic congenital heart disease and requires early surgical correction, this is a case of a patient who at six months undergoes palliative pulmonary systemic bypass surgery with modified Blalock Taussing fistula with Goretex graft, his condition does not improve with the passing of the years and a total correction surgery must be performed. Upon admission, the patient presents: dyspnea of medium efforts, asthenia, peribucal and distal cyanosis that yield with rest; in thorax presence of infra axillary scar compatible with previous palliative surgery, heart: rhythmic R1 and R2, phonetic norm, presence of holosystolic murmur in pulmonary focus and left infraclavicular murmur of pulmonary systemic fistula.

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Right ventricular remodeling after conduit replacement in patients with corrected tetralogy of Fallot - evaluation by cardiac magnetic resonance

Cited by 10 publications

References 30 publications

Long-Term Outcome Following Pulmonary Valve Replacement in Repaired Tetralogy of Fallot

Long-Term Outcome Following Pulmonary Valve Replacement in Repaired Tetralogy of Fallot

The predictive role of right ventricular late gadolinium enhancement in patients with tetralogy of Fallot undergoing pulmonary valve replacement

Informe de caso y revisión bibliográfica: Tetralogía de Fallot

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