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Eur Heart J Cardiovasc Imaging 2019 Apr 16. Epub 2019 Apr 16.

Department of Cardiovascular Imaging, Hôpital Cardiologique du Haut-Lévêque, CHU de Bordeaux, Avenue de Magellan, 33604 Pessac, France.

Aims: To identify the correlates of focal scar and diffuse fibrosis in patients with history of tetralogy of Fallot (TOF) repair.

Methods And Results: Consecutive patients with prior TOF repair underwent electrocardiogram, 24-h Holter, transthoracic echocardiography, exercise testing, and cardiac magnetic resonance (CMR) including cine imaging to assess ventricular volumes and ejection fraction, T1 mapping to assess left ventricular (LV) and right ventricular (RV) diffuse fibrosis, and free-breathing late gadolinium-enhanced imaging to quantify scar area at high spatial resolution. Structural imaging data were related to clinical characteristics and functional imaging markers. Read More

J Cardiothorac Surg 2019 Apr 15;14(1):77. Epub 2019 Apr 15.

Department of Cardiothoracic Surgery, Clinical sciences, Lund University, Skane University Hospital, SE-221 85, Lund, Sweden.

Purpose: To evaluate the potential for right ventricular reverse remodelling after pulmonary valve replacement using cardiac magnetic resonance imaging, in adults with corrected tetralogy of Fallot and severe pulmonary insufficiency.

Material And Methods: Ten patients with previous correction of tetralogy of Fallot with severe pulmonary insufficiency accepted for pulmonary valve replacement were evaluated prospectively with cardiac magnetic resonance imaging preoperatively and re-evaluated 10 ± 5 months postoperatively. Follow up for survival was 100% complete with mean of 37 ± 12 months. Read More

Medicine (Baltimore) 2019 Apr;98(15):e15203

Department of Otolaryngology-Head and Neck Surgery, First Hospital of Jilin University, Jilin University, Changchun 130021, Jilin Province, China.

Rationale: Ganglioneuromas are benign neoplasm of neuroblastic origin which arise from central or peripheral parts of the autonomic nervous system. They are normally found at posterior mediastinum, retroperitoneum, and the adrenal gland but ganglioneuromas are rarely found in the cervical region.

Patient Concerns: A 12-year-old boy was admitted with a left-lateral neck mass slow growing over a 7-days duration. Read More

Congenit Heart Dis 2019 Apr 8. Epub 2019 Apr 8.

Department of Cardiovascular Medicine, Mayo Clinic Rochester, Rochester, Minnesota.

Background: We hypothesized that echocardiographic indices of right ventricular to pulmonary artery (RV-PA) coupling were comparable to cardiac magnetic resonance imaging (CMRI)-derived RV volumetric indices in predicting disease severity in chronic pulmonary regurgitation (PR).

Methods: Patients with ≥ moderate PR (2003-2015) with and without prior CMRI scans were enrolled into the study cohort and validation cohort, respectively. Endpoint was to determine the association between noninvasive RV-PA coupling indices (tricuspid annular plane systolic excursion/right ventricular systolic pressure [TAPSE/RVSP] and fractional area change [FAC]/RVSP ratio) and markers of disease severity, and compared this association to that of CMRI-derived RV volumetric indices and markers of disease severity (peak oxygen consumption [VO ], NT-proBNP and atrial and/or ventricular arrhythmias). Read More

JACC Cardiovasc Imaging 2019 Apr;12(4):637-651

Division of Pediatric Cardiology, Mayo Clinic, Rochester, Minnesota; Division of Cardiovascular Diseases, Mayo Clinic, Rochester, Minnesota. Electronic address:

Tricuspid valve abnormalities in congenital heart disease comprise a wide spectrum, with the most common being Ebstein anomaly and tricuspid valve dysplasia. Tricuspid valve dysfunction may also be secondary to other types of congenital heart disease, including functional tricuspid regurgitation seen in right heart volume overload conditions, such as atrial septal defect and repaired tetralogy of Fallot with severe pulmonary valve regurgitation. Congenitally corrected transposition and Mustard and Senning procedures maintain the right ventricle as the systemic ventricle, and the tricuspid valve is subject to unique hemodynamic stress not typically seen in normal circulation. Read More

Int J Cardiovasc Imaging 2019 Apr 1. Epub 2019 Apr 1.

Department of Diagnostic and Interventional Radiology, University of Leipzig - Heart Centre, Strümpellstrasse 39, 04289, Leipzig, Germany.

To compare contrast-enhanced magnetic resonance angiography (ceMRA) and 3D steady-state free precession (SSFP) during systole and diastole for assessment of the right ventricle outflow tract (RVOT) in patients considered for percutaneous pulmonary valve implantation (PPVI) after tetralogy of Fallot (TOF) repair. We retrospectively evaluated 89 patients (male: 45, mean age 19 ± 8 years), who underwent cardiac-MRI after surgical TOF-repair. Datasets covering the whole heart in systole and diastole were acquired using ECG-gated 3D SSFP and non-gated ceMRA. Read More

JACC Cardiovasc Imaging 2019 Mar 8. Epub 2019 Mar 8.

Eur Heart J Cardiovasc Imaging 2019 Mar 14. Epub 2019 Mar 14.

The Heart Centre for Children, The Children's Hospital at Westmead, Corner of Hawkesbury Road and Hainsworth Street, Westmead, New South Wales 2145, Australia.

Aims: Pulmonary regurgitation (PR) and right ventricular (RV) dilatation are common in repaired tetralogy of Fallot (rTOF). Left ventricular (LV) dysfunction is an important risk factor in rTOF. The effect of PR/RV dilatation on LV performance and RV-LV interactions in rTOF are incompletely understood. Read More

J Thorac Imaging 2019 Mar 11. Epub 2019 Mar 11.

Radiology Unit, IRCCS Policlinico San Donato.

Objective: The objective of this study was to compare the use of pulmonary regurgitation volume (PRV) or indexed PRV (PRVi) with that of pulmonary regurgitation fraction (PRF) in the assessment of patients with pulmonary regurgitation (PR) undergoing cardiac magnetic resonance (CMR) imaging.

Materials And Methods: CMR of 176 patients with PR were retrospectively evaluated. Their right ventricular diastolic (end-diastolic volume index [EDVi]) and systolic (end-systolic volume index) volume indexes, stroke volume, and ejection fraction were obtained from cine CMR sequences, whereas phase-contrast flow sequences were analyzed to obtain PRV, PRVi, and PRF. Read More

Chin Med J (Engl) 2019 03;132(6):744-748

Department of Echocardiography, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart Lung and Blood Vessel Diseases, Beijing 100029, China.

Congenit Heart Dis 2019 Mar 7. Epub 2019 Mar 7.

Department of Cardiology, Erasmus Medical Center, Rotterdam, The Netherlands.

Aims: Reliable evaluation of the severity and consequences of pulmonary regurgitation (PR) in patients with repaired tetralogy of Fallot (TOF) is crucial to timely identify the need for pulmonary valve intervention. We aimed to identify the accuracy of echocardiographic parameters to differentiate between moderate and severe PR, using phase contrast cardiac magnetic resonance imaging (CMR) as gold standard.

Methods And Results: In this cross-sectional study, 45 TOF patients with both echocardiographic and CMR measurements of PR were enrolled. Read More

Eur Rev Med Pharmacol Sci 2019 Feb;23(4):1698-1709

Department of Cardiology and Cardiac Surgery, Bambino Gesù Children's Hospital, IRCCS Rome, Italy.

Objective: The patients with repaired Tetralogy of Fallot (rToF) are a growing population due to the improvement of surgical management in neonatal age. However, the significant pulmonary regurgitation, consequent to the repair, is the most frequent sequelae and leads to a progressive right ventricle dilation over time. The latter, in turn, is responsible for the possible dysfunction of right and/or left ventricle and an increased risk of dangerous ventricular arrhythmias. Read More

Int J Cardiol 2019 May 11;283:107-111. Epub 2019 Feb 11.

Fondazione G. Monasterio CNR-Regione Toscana, Pisa, Italy.

Background: While left atrial (LA) size has been shown as a strong predictor of cardiovascular diseases in various studies, the role of right atrial (RA) enlargement, especially in the growing population of patients with congenital heart diseases (CHD) is largely unknown. We sought to evaluate (1) RA and LA volumes in patients with repaired Tetralogy of Fallot (TOF) and assess correlations to (2) functional parameters and (3) clinical adverse events.

Methods: 169 patients with repaired TOF were enrolled following a targeted protocol for Cardiovascular magnetic resonance imaging (CMR), Cardiopulmonary exercise tests (CPET), Echocardiography and Measurement of NT-proBNP. Read More

J Med Case Rep 2019 Feb 5;13(1):30. Epub 2019 Feb 5.

Department of Pediatric Cardiovascular Surgery, Kyoto Prefectural University of Medicine, Kyoto, Japan.

Background: Pulmonary regurgitation is a common complication after tetralogy of Fallot repair, resulting in right ventricular dysfunction, arrhythmia, and sudden death. However, the indications and optimal timing for pulmonary valve replacement are not fully known. We describe a case in which a four-dimensional imaging tool was useful in the decision to re-operate, thus resulting in decreased energy loss and improved right ventricular function after the re-operation for tetralogy of Fallot. Read More

Int J Cardiovasc Imaging 2019 Feb 4. Epub 2019 Feb 4.

Department of Radiology, Feinberg School of Medicine, Northwestern University, 737 N. Michigan Avenue, Suite 1600, Chicago, IL, 60611, USA.

The assessment of both left (LV) and right ventricular (RV) motion is important to understand the impact of heart disease on cardiac function. The MRI technique of tissue phase mapping (TPM) allows for the quantification of regional biventricular three-directional myocardial velocities. The goal of this study was to establish normal LV and RV velocity parameters across a wide range of pediatric to adult ages and to investigate the feasibility of TPM for detecting impaired regional biventricular function in patients with repaired tetralogy of Fallot (TOF). Read More

J Magn Reson Imaging 2019 Feb 4. Epub 2019 Feb 4.

Pediatric Cardiology and Congenital Heart Disease, German Heart Center at Technical University of Munich, Munich, Germany.

Background: Alterations in wall shear stress (WSS) assessed using 4D flow MRI have been shown to play a role in various vascular pathologies, such as bicuspid aortic valve aortopathy. Most studies have focused on systolic WSS, whereas altered diastolic hemodynamics in regurgitant semilunar valvular lesions have not so far been well characterized.

Purpose: To investigate diastolic WSS in aortic and pulmonary regurgitation. Read More

Korean J Radiol 2019 Jan 27;20(1):102-113. Epub 2018 Dec 27.

Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea.

Objective: To assess the accuracy and potential bias of computed tomography (CT) ventricular volumetry using semiautomatic three-dimensional (3D) threshold-based segmentation in repaired tetralogy of Fallot, and to compare them to those of two-dimensional (2D) magnetic resonance imaging (MRI).

Materials And Methods: This retrospective study evaluated 32 patients with repaired tetralogy of Fallot who had undergone both cardiac CT and MRI within 3 years. For ventricular volumetry, semiautomatic 3D threshold-based segmentation was used in CT, while a manual simplified contouring 2D method was used in MRI. Read More

BMC Cardiovasc Disord 2019 Jan 7;19(1). Epub 2019 Jan 7.

Mid-German Heart Center, Department of Internal Medicine III (KIM-III), Division of Cardiology, Angiology and Intensive Medical Care, University Hospital Halle, Martin-Luther-University Halle, Ernst-Grube-Strasse 40, D-06120, Halle (Saale), Germany.

Advances in the medical and surgical management of Tetralogy of Fallot have led to marked increase of the number and age of survivors. Imaging in patients with Tetralogy of Fallot plays a crucial role in the diagnosis and follow up, and essentially guides management and intervention in this entity. This study systematically reviews the imaging modalities used in patients with Tetralogy of Fallot in the evaluation of preoperative and postoperative anatomic and hemodynamic lesions, as well as disease progression in this diagnosis. Read More

Pediatr Cardiol 2019 Feb 2;40(2):404-411. Epub 2019 Jan 2.

Division of Cardiology, Carman and Ann Adams Department of Pediatrics, Children's Hospital of Michigan, 3901 Beaubien Blvd, Detroit, MI, 48201-2119, USA.

Background: In patients with repaired Tetralogy of Fallot (rTOF), pulmonary regurgitation (PR) leads to significant morbidity. Cardiac magnetic resonance imaging (CMR) is the gold standard to assess severity of PR in rTOF patients. We compared Doppler echocardiography derived indices of PR with CMR to find the best predictive parameter for hemodynamically significant (hs) PR. Read More

Eur J Radiol 2019 Jan 22;110:88-96. Epub 2018 Nov 22.

Department of Radiology, Erasmus Medical Center, 's Gravendijkwal 230, 3015, CE Rotterdam, The Netherlands; Department of Cardiology, Erasmus Medical Center, 's Gravendijkwal 230, 3015, CE Rotterdam, The Netherlands.

Background: Coronary compression (CC) is a life threatening complication that can occur during percutaneous pulmonary valve implantation (PPVI). We describe our experience using cardiac CT prior to PPVI to identify patients at high CC-risk due to a close relationship between the coronary arteries and pulmonary trunk (PT).

Methods: A retrospective evaluation of candidates for PPVI who underwent CT prior to the procedure was done. Read More

PLoS One 2018 31;13(12):e0208749. Epub 2018 Dec 31.

Aix-Marseille Univ, CNRS, CRMBM, Marseille, France.

Background: The aim of our study was to evaluate the feasibility of exercise cardiac magnetic resonance (CMR) in patients with repaired tetralogy of Fallot (RTOF) and to assess right and left ventricular adaptation and aortic wall response to exercise in comparison with volunteers.

Methods: 11 RTOF and 11 volunteers underwent prospective CMR at rest and during exercise. A supine bicycle ergometer was employed to reach twice the resting heart rate during continuous exercise, blood pressure and heart rate were recorded. Read More

Paediatr Anaesth 2018 Dec 28. Epub 2018 Dec 28.

Department of Anesthesiology, Critical Care and Pain Medicine, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts.

Recent advances in catheterization and imaging technology allow for more complex procedures to be performed in the catheterization laboratory. A number of lesions are now amenable to a percutaneous procedure, eliminating or at least postponing the need for a surgical intervention. Due to the increase in the complexity of the procedures performed, the involvement of anesthesiologists and their close collaboration with the interventional cardiologists have increased. Read More

J Am Heart Assoc 2019 Jan;8(1):e010689

1 Pediatric Cardiac Surgery Center National Center for Cardiovascular Disease and Fuwai Hospital Chinese Academy of Medical Sciences Peking Union Medical College Beijing China.

Background Although right ventricular ( RV ) volume was significantly decreased in symptomatic patients with repaired tetralogy of Fallot ( rTOF ) after pulmonary valve replacement ( PVR ), RV size was still enlarged along with RV dysfunction. Methods and Results A prospective case-control study was conducted in a tertiary hospital; 81 asymptomatic repaired tetralogy of Fallot patients with moderate or severe pulmonary regurgitation were enrolled. The enrolled cohort was divided into 2 groups: PVR group (n=41) and medication group (n=40). Read More

Echocardiography 2019 02 25;36(2):411-414. Epub 2018 Dec 25.

Division of Pediatric Cardiology, Stanford University and University of California San Francisco, San Francisco, California.

Background: Aortopulmonary window is a rare conotruncal defect that is often associated with other congenital heart defects. We present a patient with a previously unreported combination of aortopulmonary window with tetralogy of Fallot with an absent conal septum.

Case Presentation: A term, 2. Read More

Asian Cardiovasc Thorac Ann 2019 Feb 22;27(2):75-79. Epub 2018 Dec 22.

1 Department of Pediatric Cardiac Surgery, Rumah Sakit Jantung dan Pembuluh Darah Nasional Harapan Kita, Jakarta, Indonesia.

Background: Cardioplegia is an integral part of myocardial protection. The superiority of blood cardioplegia in adult patients has been reported. However, this is yet to be studied in cyanotic pediatric patients. Read More

Circ Cardiovasc Imaging 2018 Dec;11(12):e007611

The Labatt Family Heart Center, Department of Pediatrics, The Hospital for Sick Children and University of Toronto, ON, Canada (L.M., M.K.F.).

Background: The study objective was to assess the severity, progression rate, and risk factors for aortic root dilatation (ARD) in pediatric tetralogy of Fallot (TOF) and to study its relationship to complications including aortic regurgitation.

Methods And Results: Seven hundred sixty-eight TOF patients were studied with echocardiography (median age at repair 6.1 months; interquartile range, 4. Read More

J Am Heart Assoc 2018 Dec;7(24):e010274

1 Department of Cardiovascular Medicine Mayo Clinic Rochester MN.

Background Patients with tetralogy of Fallot ( TOF ) remain at risk for cardiovascular events despite successful repair. Some of the current risk stratification tools require advanced imaging and invasive studies, and hence are difficult to apply to routine patient care. A recent study showed that QRS fragmentation ( QRS -f) is predictive of mortality in patients with TOF. Read More

Echo Res Pract 2019 Mar;6(1):R9-R23

Department of Pediatric and Adult Congenital Cardiology, Hôpital Cardiologique du Haut-Lévêque, CHU de Bordeaux, Pessac, France.

Tetralogy of Fallot (TOF) is the most common cyanotic congenital heart defect, affecting 3 in 10,000 live births. Surgical correction in early childhood is associated with good outcomes, but lifelong follow-up is necessary to identify the long-term sequelae that may occur. This article will cover the diagnosis of TOF in childhood, the objectives of surveillance through adulthood and the value of multi-modality imaging in identifying and guiding timely surgical and percutaneous interventions. Read More

Pediatr Cardiol 2019 Mar 11;40(3):616-622. Epub 2018 Dec 11.

Division of Pediatric Cardiology, University of Nebraska College of Medicine and Children's Hospital and Medical Center, 8200 Dodge St, Omaha, NE, 68114, USA.

Quantification of pulmonary regurgitation (PR), pulmonary flow distribution, and ventricular function is important for clinical surveillance in repaired Tetralogy of Fallot (TOF). Cardiovascular magnetic resonance (CMR) is the established reference, but cost, test duration, and patient discomfort are potential limitations to its serial use. We investigated whether an Abbreviated CMR protocol would alter clinical decisions in TOF from those that would have been made using a full protocol. Read More

Pediatr Radiol 2019 Mar 1;49(3):308-317. Epub 2018 Dec 1.

Department of Radiology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA.

Background: Cardiac MRI plays a central role in monitoring children with repaired tetralogy of Fallot (TOF) for long-term complications. Current risk assessment is based on volumetric and functional parameters that measure late expression of underlying physiological changes. Emerging 4-D flow MRI techniques promise new insights. Read More

Int J Cardiol 2019 02 22;276:116-117. Epub 2018 Nov 22.

Polito(BIO)Med Lab, Department of Mechanical and Aerospace Engineering, Politecnico di Torino, Turin, Italy.

Heart 2018 Dec 4. Epub 2018 Dec 4.

Toronto Congenital Cardiac Centre for Adults, Peter Munk Cardiac Centre, University of Toronto, Toronto General Hospital, Toronto, Ontario, Canada.

Objective: The relationship between right ventricular (RV) fibrosis and right heart reverse remodelling following pulmonary valve replacement (PVR) has not been well studied in adults with repaired tetralogy of Fallot (rTOF). Our aims were to histologically quantify RV fibrosis and to explore the relationship between fibrosis severity and cardiac remodelling post-PVR.

Methods: Adults with rTOF and pre-PVR cardiovascular (CMR) imaging were consented to procurement of RV muscle during PVR. Read More

Heart 2018 Dec 4. Epub 2018 Dec 4.

Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota, USA.

Background: Aortic dilation and aortic valve disease are known long-term complication of tetralogy of Fallot (TOF), but the risk of aortic dissection and the indications for prophylactic aortic surgery are unknown in this population. The purpose of this study was to: (1) determine the prevalence of significant aortic valve disease and/or significant aortic aneurysm (AVD-AA); (2) determine the incidence of progressive aortic dilation and aortic dissection in patients with TOF.

Methods: Retrospective review of adults with repaired TOF, and no prior aortic valve/aorta surgery, who had ≥2 measurements of the thoracic aorta >12 months apart, 1990-2017. Read More

Ann Thorac Surg 2018 Nov 17. Epub 2018 Nov 17.

Department of Pediatrics, University of Michigan C.S. Mott Children's Hospital, Ann Arbor, Michigan.

Background: The Pediatric Heart Network Collaborative Learning Study (PHN CLS) increased early extubation rates after infant tetralogy of Fallot (TOF) and coarctation of the aorta (CoA) repair across participating sites by implementing a clinical practice guideline (CPG). The impact of the CPG on hospital costs has not been studied.

Methods: PHN CLS clinical data were linked to cost data from Children's Hospital Association by matching on indirect identifiers. Read More

J Thorac Cardiovasc Surg 2018 Dec 21;156(6):2239-2249. Epub 2018 Sep 21.

Section of Congenital Heart Surgery, Heart Institute, Children's Hospital Colorado, University of Colorado Denver | Anschutz Medical Campus, Aurora, Colo.

Objective: Patients with tetralogy of Fallot are at risk for late aortic complications due to progressive aortic root dilation and decreased aortic compliance. Early repair normalizes aortic dimensions by preadolescence. It is not known if early repair normalizes aortic wall histology and compliance or reduces late aortic complications. Read More

Prog Cardiovasc Dis 2018 Nov - Dec;61(5-6):468-475. Epub 2018 Nov 13.

Department of Cardiovascular Disease, John Ochsner Heart and Vascular Institute, Ochsner Clinical School - The University of Queensland School of Medicine, New Orleans, LA, United States of America. Electronic address:

As the prevalence of adult congenital heart disease continues to grow secondary to advances in surgical and diagnostic techniques, it is important for a physician to supplement their examinations with non-invasive imaging techniques to assess their patients. Although a number of these patients have regular cardiology followup, some may be new patients that do not even know their cardiac history. Echocardiography has proven to be a useful tool for this purpose and its utility has expanded drastically with the development of better technology and newer techniques. Read More

Catheter Cardiovasc Interv 2019 Feb 15;93(3):E143-E152. Epub 2018 Nov 15.

Division of Cardiology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania.

Background: Pulmonary insufficiency is a consequence of transannular patch repair in Tetralogy of Fallot (ToF) leading to late morbidity and mortality. Transcatheter native outflow tract pulmonary valve replacement has become a reality. However, predicting a secure, atraumatic implantation of a catheter-based device remains a significant challenge due to the complex and dynamic nature of the right ventricular outflow tract (RVOT). Read More

Conf Proc IEEE Eng Med Biol Soc 2018 Jul;2018:1115-1118

Four-dimensional phase-contrast (PC) velocity-encoded flow magnetic resonance imaging (4D flow MRI) is a potentially valuable tool for studying cardiovascular hemodynamics for disease monitoring and/or treatment planning. In this study we compared the performance of two 4D flow MRI pulse sequences - echo-planar imaging (EPI) and segmented gradient-echo (turbo-field-echo or TFE on vendor's platform) - on a clinical 3T system in 6 human subjects including 3 patients with Tetralogy of Fallot (TOF). For aortic flow rate, the coefficients of variation (COV) between 2D and 4D EPI were 7. Read More

Cardiol Young 2019 Jan 31;29(1):88-89. Epub 2018 Oct 31.

Children's Hospital of Orange County,Pediatric Heart Institute,Orange,CA 92868,USA.

We present a pilot case using an innovative fusion of echocardiogram and MRI achieved with a MATLAB-based imaging programme to explore the feasibility of this imaging strategy in the functional and anatomic assessment of a patient with repaired tetralogy of Fallot requiring pulmonary valve intervention. Echocardiogram and MRI neutralises the disadvantages and limitations of each individual imaging modality and yields important anatomic and haemodynamic information crucial to the treatment decision-making process. Future image fusion strategies can apply to three-dimensional images and image-directed therapy for CHD. Read More

Cardiol Young 2019 Jan 30;29(1):59-66. Epub 2018 Oct 30.

Department of Cardiology,Boston Children's Hospital,Harvard Medical School,Boston,MA,USA.

Background: The American College of Cardiology Quality Network enables national benchmarking and collaborative quality improvement through vetted metrics. We describe here our initial experience with the Quality Network.

Methods: Quarterly data for metrics pertaining to chest pain, Kawasaki disease, tetralogy of Fallot, elevated body mass index, and others were shared with the collaboratives for benchmarking. Read More

BMJ Case Rep 2018 Oct 28;2018. Epub 2018 Oct 28.

Department of Cardiovascular Radiology and Endovascular Interventions, All India Institute of Medical Sciences, New Delhi, India.

Cardiovasc Ultrasound 2018 Oct 29;16(1):28. Epub 2018 Oct 29.

Department of Cardiac and Vascular Disease, Collegium Medicum, Jagiellonian University, John Paul II Hospital, Krakow, Poland.

Background: Tetralogy of Fallot (ToF) is the most common cyanotic congenital heart disease and the population of ToF repair survivors is growing rapidly. Adults with repaired ToF develop late complications. The aim of this study was to describe and analyze long-term follow-up of patients with repaired ToF. Read More

Circ Arrhythm Electrophysiol 2018 Oct;11(10):e006059

IHU LIRYC, L'Institut de Rythmologie et Modélisation Cardiaque, Fondation Bordeaux Université, Pessac, France (V.D., D.B., F.R., S.H.G., M.C., S.C., D.E., B.Q., H.C., M.H., C.R., P.B., J.-B.T., O.B.).

Background: Ventricular arrhythmias are frequent in patients with repaired tetralogy of Fallot (rTOF), but their origin and underlying mechanisms remain unclear. In this study, the involvement of left ventricular (LV) electrical and structural remodeling was assessed in an animal model mimicking rTOF sequelae.

Methods: Piglets underwent a tetralogy of Fallot repair-like surgery (n=6) or were sham operated (Sham, n=5). Read More

Proc IEEE Int Symp Biomed Imaging 2018 Apr 24;2018:1309-1312. Epub 2018 May 24.

Division of Cardiology, Children's Hospital Los Angeles, CA, USA.

Long-term outcomes for Tetralogy of Fallot (TOF) have improved dramatically in recent years, but survivors are still afflicted by cerebral damage. In this paper, we characterized the prevalence and predictors of cerebral silent infarction (SCI) and their relationship to cerebral blood flow (CBF) in 46 adult TOF patients. We calculated both whole brain and regional CBF using 2D arterial spin labeling (ASL) images, and investigated the spatial overlap between voxel-wise CBF values and white matter hyperintensities (WMHs) identified from T2-FLAIR images. Read More

Mol Imaging Radionucl Ther 2018 Oct;27(3):146-148

Bari University Aldo Moro, Unit of Nuclear Medicine, Bari, Italy

Congenital heart diseases, such as tetralogy of fallot (TOF), are the most common human birth defects that may cause pulmonary diseases. Lung perfusion scintigraphy (LPS) has an important role in evaluating pulmonary involvement in patients with these defects, both as part of the diagnostic work-up and for follow-up to guide best therapeutic strategy. Herein, we report a 10-year-old female patient with TOF who underwent LPS two years after cardiac surgery. Read More

J Am Soc Echocardiogr 2019 Jan 27;32(1):135-144. Epub 2018 Sep 27.

Division of Cardiology, Department of Pediatrics, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania.

Background: Pulmonary insufficiency (PI) and right ventricular (RV) dysfunction are long-term complications in patients with repaired tetralogy of Fallot (rTOF). The aim of this study was to investigate RV contractile reserve and changes in PI that occur during exercise in patients with rTOF and the associations of these changes with exercise performance using stress echocardiography.

Methods: Subjects with rTOF (n = 32) and healthy control subjects (n = 10) were prospectively enrolled and underwent rest and peak exercise echocardiography during standard cardiopulmonary exercise test protocol on a cycle ergometer or treadmill. Read More

Am J Physiol Heart Circ Physiol 2018 Dec 28;315(6):H1691-H1702. Epub 2018 Sep 28.

Lund University, Department of Clinical Sciences, Lund, Clinical Physiology, Skåne University Hospital , Sweden.

Intracardiac hemodynamic forces have been proposed to influence remodeling and be a marker of ventricular dysfunction. We aimed to quantify the hemodynamic forces in patients with repaired tetralogy of Fallot (rToF) to further understand the pathophysiological mechanisms as this could be a potential marker for pulmonary valve replacement (PVR) in these patients. Patients with rToF and pulmonary regurgitation (PR) > 20% ( n = 18) and healthy control subjects ( n = 15) underwent MRI, including four-dimensional flow. Read More

PLoS One 2018 27;13(9):e0204435. Epub 2018 Sep 27.

Department of Clinical Physiology and Department of Medical and Health Sciences, Linkoping University, Linkoping, Sweden.

Background: Prior studies suggested that myocardial deformation is superior to conventional measures for assessing ventricular function. This study aimed to evaluate right ventricular (RV) myocardial deformation in response to increased afterload. Patients with the RV in the systemic position were compared with patients with the RV in the sub-pulmonic position with normal or only slightly elevated systolic right ventricular pressure. Read More

J Cardiovasc Med (Hagerstown) 2018 Nov;19(11):643-649

Department of Cardiovascular Medicine, Pediatric Cardiology and Adult Congenital Heart Disease Program.

Background: Proper integration of multiple imaging modalities in the routine follow-up of patients with repaired tetralogy of Fallout (TOF) is poorly supported by data. We report our single center comparative study between cardiac magnetic resonance (CMR) and echocardiography to assess equipoise in the clinical utility of these two imaging methods in an unselected consecutive cohort of TOF patients referred to our outpatient clinic.

Material And Methods: In this cross-sectional study, repaired TOF patients who underwent CMR and echocardiography within a 4-week period between 2010 and 2011 at our Center were included. Read More

Congenit Heart Dis 2018 Nov 19;13(6):1045-1049. Epub 2018 Sep 19.

Department of Pediatrics (Cardiology), University of Arizona, Tucson, Arizona.

Objective: Applications of three-dimensional (3D) printed models in medicine include preprocedure planning, patient education, and clinical training. Reproducing complex anatomy as a 3D printed model can be useful for understanding congenital heart defects (CHD). We hypothesized that using 3D printed models during didactic sessions with resident physicians will improve trainees' understanding of CHD. Read More