The challenges of an aging tetralogy of Fallot population

Woo, Jennifer P; McElhinney, Doff B.

doi:10.1080/14779072.2021.1940960

Cited by 8 publications

(5 citation statements)

References 148 publications

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“…About 20% of adults with repaired ToF will develop atrial arrhythmia [2][3][4]. Intraatrial reentrant tachycardia (IART) is second (after ventricular tachycardia) most common single arrhythmia subtype followed by AF in this population.…”

Section: Discussionmentioning

confidence: 99%

Arrhythmias And Long-Term Hemodynamic Consequences In Patient With Repaired Tetralogy Of Fallot – A Case Study

Rutkowski

Kołodzińska

Koźluk

et al. 2023

J Educ Health Sport

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The number of patients who underwent total correction of Tetralogy of Fallot (ToF) in early life or infancy is still rising. According to CDC ToF is the most prevalent cyanotic congenital heart disease with incidences of 1 in 2500 births. Rhythm disturbances and haemodynamic disturbances including valves disorders, heart failure, residual defects and more are new challenges for clinicians taking care of adult patients with repaired ToF. Our goal was to describe such a patient and highlight further complications which may be encountered among those patients.

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Section: Discussionmentioning

confidence: 99%

Arrhythmias And Long-Term Hemodynamic Consequences In Patient With Repaired Tetralogy Of Fallot – A Case Study

Rutkowski

Kołodzińska

Koźluk

et al. 2023

J Educ Health Sport

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“…The improvements in surgical repair of TOF enable more patients to reach adulthood ( 27 ). The corrective surgery, however, is not curative and decades after repair, adults are often faced with the consequences of chronic pulmonary regurgitation (PR) that requires implanting valve substitutes in RVOT ( 28 ). Despite the necessity of redo-RVOT reconstruction as the sequelae of primary repair, the risk of it is quite low, with early and late patient mortality being 1.95 and 0.59%/y.…”

Section: Discussionmentioning

confidence: 99%

Outcomes after right ventricular outflow tract reconstruction with valve substitutes: A systematic review and meta-analysis

Wang

Bakhuis

Veen

et al. 2022

Front. Cardiovasc. Med.

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IntroductionThis study aims to provide an overview of outcomes after right ventricular outflow tract (RVOT) reconstruction using different valve substitutes in different age groups for different indications.MethodsThe literature was systematically searched for articles published between January 2000 and June 2021 reporting on clinical and/or echocardiographic outcomes after RVOT reconstruction with valve substitutes. A random-effects meta-analysis was conducted for outcomes, and time-related outcomes were visualized by pooled Kaplan–Meier curves. Subgroup analyses were performed according to etiology, implanted valve substitute and patient age.ResultsTwo hundred and seventeen articles were included, comprising 37,078 patients (age: 22.86 ± 11.29 years; 31.6% female) and 240,581 patient-years of follow-up. Aortic valve disease (Ross procedure, 46.6%) and Tetralogy of Fallot (TOF, 27.0%) were the two main underlying etiologies. Homograft and xenograft accounted for 83.7 and 32.6% of the overall valve substitutes, respectively. The early mortality, late mortality, reintervention and endocarditis rates were 3.36% (2.91–3.88), 0.72%/y (95% CI: 0.62–0.82), 2.62%/y (95% CI: 2.28–3.00), and 0.38%/y (95%CI: 0.31–0.47) for all patients. The early mortality for TOF and truncus arteriosus (TA) were 1.95% (1.31–2.90) and 10.67% (7.79–14.61). Pooled late mortality and reintervention rate were 0.59%/y (0.39–0.89), 1.41%/y (0.87–2.27), and 1.20%/y (0.74–1.94), 10.15%/y (7.42–13.90) for TOF and TA, respectively. Endocarditis rate was 0.21%/y (95% CI: 0.16–0.27) for a homograft substitute and 0.80%/y (95%CI: 0.60–1.09) for a xenograft substitute. Reintervention rate for infants, children and adults was 8.80%/y (95% CI: 6.49–11.95), 4.75%/y (95% CI: 3.67–6.14), and 0.72%/y (95% CI: 0.36–1.42), respectively.ConclusionThis study shows RVOT reconstruction with valve substitutes can be performed with acceptable mortality and morbidity rates for most patients. Reinterventions after RVOT reconstruction with valve substitutes are inevitable for most patients in their life-time, emphasizing the necessity of life-long follow-up and multidisciplinary care. Follow-up protocols should be tailored to individual patients because patients with different etiologies, ages, and implanted valve substitutes have different rates of mortality and morbidity.Systematic review registration[www.crd.york.ac.uk/prospero], identifier [CRD42021271622].

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“…Neurodevelopment has been understudied in patients with TOF, despite this being a prevalent and growing population of survivors of heart surgery (50). Adolescents with TOF, even without a genetic syndrome, test lower than their peers in several neuro-cognitive domains, including executive function, visualspatial skills, memory, attention, academic achievement and social cognition.…”

Section: Neurodevelopment In Adolescents and Young Adults With Tofmentioning

confidence: 99%

Neurodevelopment in patients with repaired tetralogy of Fallot

Mercer-Rosa,

Favilla

2024

Front. Pediatr.

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Neurodevelopmental sequelae are prevalent and debilitating for patients with congenital heart defects. Patients born with tetralogy of Fallot (TOF) are susceptible for abnormal neurodevelopment as they have several risk factors surrounding the perinatal and perioperative period. Some risk factors have been well described in other forms of congenital heart defects, including transposition of the great arteries and single ventricle heart disease, but they have been less studied in the growing population of survivors of TOF surgery, particularly in infancy and childhood. Adolescents with TOF, even without a genetic syndrome, exhibit neuro-cognitive deficits in executive function, visual-spatial skills, memory, attention, academic achievement, social cognition, and problem-solving, to mention a few. They also have greater prevalence of anxiety disorder, disruptive behavior and attention-deficit hyperactivity disorder. These deficits impact their academic performance, social adjustment, and quality of life, thus resulting in significant stress for patients and their families. Further, they can impact their social adjustment, employment and career development as an adult. Infants and younger children can also have significant deficits in gross and fine motor skills, cognitive deficits and abnormal receptive language. Many of the risk factors associated with abnormal neurodevelopment in these patients are not readily modifiable. Therefore, patients should be referred for evaluation and early intervention to help maximize their neurodevelopment and improve overall outcomes. More study is needed to identify potentially modifiable risk factors and/or mediators of neurodevelopment, such as environmental and socio-economic factors.

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The challenges of an aging tetralogy of Fallot population

Cited by 8 publications

References 148 publications

Arrhythmias And Long-Term Hemodynamic Consequences In Patient With Repaired Tetralogy Of Fallot – A Case Study

Arrhythmias And Long-Term Hemodynamic Consequences In Patient With Repaired Tetralogy Of Fallot – A Case Study

Outcomes after right ventricular outflow tract reconstruction with valve substitutes: A systematic review and meta-analysis

Neurodevelopment in patients with repaired tetralogy of Fallot

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