12,669 results match your criteria Tetralogy of Fallot


How and When Should Tetralogy of Fallot be Palliated Prior to Complete Repair?

Semin Thorac Cardiovasc Surg Pediatr Card Surg Annu 2021 ;24:77-84

Hospital for Sick Children, Department of Surgery, Division of Cardiovascular Surgery, Toronto, Ontario, Canada.

The controversy regarding the best or ideal surgical management of Tetralogy of Fallot (ToF) stems from the recognition of there being a spectrum of morphology and associated lesions, each of which require a different approach to achieve the three goals of minimizing mortality preserving right ventricular function long-term and minimizing reinterventions. A one-size-fits-all approach to ToF needs to be replaced by a considered and personalized approach in order to yield the best outcomes possible for individual patients. The great majority of patients with ToF undergo primary complete repair between age 3-9 months with excellent outcomes. Read More

View Article and Full-Text PDF
January 2021

Coronary cannulation challenge in a patient with tetralogy of fallot history and myocardial infarction.

Eur Heart J Case Rep 2021 Mar 25;5(3):ytab023. Epub 2021 Mar 25.

Cardiology Department, Hedi Chaker Hospital, Research Unit UR17ES37, University of Medicine, Sfax University, Tunisia.

View Article and Full-Text PDF

Rare variants in KDR, encoding VEGF Receptor 2, are associated with tetralogy of Fallot.

Genet Med 2021 Jun 10. Epub 2021 Jun 10.

University of Nottingham, Queen's Medical Centre, Nottingham, UK.

Purpose: Rare genetic variants in KDR, encoding the vascular endothelial growth factor receptor 2 (VEGFR2), have been reported in patients with tetralogy of Fallot (TOF). However, their role in disease causality and pathogenesis remains unclear.

Methods: We conducted exome sequencing in a familial case of TOF and large-scale genetic studies, including burden testing, in >1,500 patients with TOF. Read More

View Article and Full-Text PDF

Cutting balloon angioplasty on branch pulmonary artery stenosis in pediatric patients.

Catheter Cardiovasc Interv 2021 Jun 10. Epub 2021 Jun 10.

Pediatric Cardiology, Arkansas Children's Hospital, Little Rock, Arkansas, USA.

Objectives: To identify medium-term results following cutting balloon angioplasty (CBA) for branch pulmonary artery stenosis (PAS) and predictors of successful intervention.

Background: CBA has emerged as a successful alternative therapy for PAS resistant to conventional balloon angioplasty techniques but there is little information on medium and long-term outcomes.

Methods: This is a descriptive, single center, retrospective chart review of pediatric patients who underwent CBA for PAS at Arkansas Children's Hospital between May 2005 and December 2020. Read More

View Article and Full-Text PDF

Correlation Between Fragmented QRS and Ventricular Function from Cardiac Magnetic Resonance in Patients with Repaired Tetralogy of Fallot.

Pediatr Cardiol 2021 Jun 10. Epub 2021 Jun 10.

Epidemiology Unit, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla, 90110, Thailand.

Fragmented QRS is an abnormal sign in an ECG resulting from ventricular dyssynchrony. The presence of fragmented QRS (fQRS) is related to mortality in patients with repaired tetralogy of Fallot (rTOF). This study aimed to analyze the correlations between fQRS and ventricular function parameters from cardiac magnetic resonance (CMR) images. Read More

View Article and Full-Text PDF

Impairment of left atrial function in pediatric patients with repaired tetralogy of Fallot: a cardiovascular magnetic resonance imaging study.

Int J Cardiovasc Imaging 2021 Jun 8. Epub 2021 Jun 8.

Diagnostic Imaging Center, Shanghai Children's Medical Center Affiliated With Shanghai Jiao Tong University School of Medicine, 1678 Dong Fang Road, Shanghai, 200127, People's Republic of China.

We aimed to assess left atrial (LA) strain before LA dilatation in patients with repaired tetralogy of Fallot (rTOF) compared with healthy controls. We also determined the effects of right atrial (RA) dilatation on LA performance using cardiovascular magnetic resonance-feature tracking (CMR-FT). Forty-nine pediatric patients with rTOF and 36 age- and sex-matched healthy controls were prospectively recruited between June 2017 and August 2019. Read More

View Article and Full-Text PDF

A comprehensive study of congenital unilateral absence of branch pulmonary artery associated with other congenital heart defects and ipsilateral non-unifocalizable major aorto-pulmonary collateral arteries: A single-center retrospective study.

Ann Pediatr Cardiol 2021 Apr-Jun;14(2):139-145. Epub 2021 Apr 10.

RXDX Healthcare and Teleradiology Solutions, Bengaluru, Karnataka, India.

Introduction: Congenital unilateral absence of pulmonary artery (UAPA) is a rare congenital anomaly with the complete absence of intrapericardial segment of one of the branch pulmonary arteries. Sixty percent are associated with other congenital heart defects (CHD) that often need correction.

Aim: To analyze the data of patients with UAPA and ipsilateral non-unifocalizable major aortopulmonary collateral arteries (MAPCAs) associated with other CHD to identify the commonly associated CHD, their management strategies and outcomes. Read More

View Article and Full-Text PDF

The challenges of an aging Tetralogy of Fallot population.

Expert Rev Cardiovasc Ther 2021 Jun 9. Epub 2021 Jun 9.

Department of Medicine, Division of Cardiovascular Medicine, Stanford University School of Medicine, California, USA.

Introduction: Advancements in surgery and management have resulted in a growing population of aging adults with tetralogy of Fallot (TOF). As a result, there has been a parallel growth in late complications associated with the sequelae from the underlying cardiac anomalies as well as the surgical and other interventional treatments.

Areas Covered: Here, we review challenges related to an aging population of patients with TOF, particularly late complications, and highlight advances in management and key areas for future research. Read More

View Article and Full-Text PDF

Contemporary Outcomes in Tetralogy of Fallot With Absent Pulmonary Valve After Fetal Diagnosis.

J Am Heart Assoc 2021 Jun 8;10(12):e019713. Epub 2021 Jun 8.

Division of Cardiology Children's National HospitalDepartment of PediatricsGeorge Washington University School of Medicine and Health Sciences Washington DC.

Background Tetralogy of Fallot with absent pulmonary valve is associated with high mortality, but it remains difficult to predict outcomes prenatally. We aimed to identify risk factors for mortality in a large multicenter cohort. Methods and Results Fetal echocardiograms and clinical data from 19 centers over a 10-year period were collected. Read More

View Article and Full-Text PDF

Substrate characterization of right ventricle in repaired tetralogy of Fallot using late enhancement cardiac magnetic resonance.

Heart Rhythm 2021 Jun 4. Epub 2021 Jun 4.

Cardiology Department, Vall d'Hebron University Hospital, Barcelona, Spain; Faculty of Medicine and Surgery, Universitat Autonoma Barcelona (UAB), Barcelona, Spain; Vall d'Hebron Research Institute (VHIR), Barcelona, Spain; Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Spain.

Background: Three-dimensional (3D) substrate characterization by high-resolution late gadolinium- enhancement cardiac magnetic resonance (LE-CMR) is useful in guiding ventricular tachycardia ablation of the left ventricle in ischemic heart disease.

Objective: This study aimed to validate the substrate characterization and 3D reconstruction of LE-CMR images of the right ventricle (RV) in patients with repaired tetralogy of Fallot (rTOF) and identify the algorithm that best fits with electroanatomical voltage mapping (EAM).

Methods: RV LE-CMR images were compared with RV EAM in 10 patients with rTOF. Read More

View Article and Full-Text PDF

Characterization of hemodynamic patterns in human fetuses with cyanotic congenital heart disease using MRI.

Ultrasound Obstet Gynecol 2021 Jun 7. Epub 2021 Jun 7.

Division of Paediatric Cardiology, Department of Paediatrics, Hospital for Sick Children, University of Toronto, Toronto, Canada.

Objectives: To characterize the distribution of blood flow and oxygen transport in human fetuses with congenital heart disease (CHD) subtypes that present with neonatal cyanosis using magnetic resonance imaging (MRI).

Methods: Blood flow was measured in the major vessels of 152 late gestation human fetuses with CHD and 40 gestational age-matched normal fetuses using cine phase contrast MRI. Oxygen saturation (SaO2) was measured in the major vessels of 57 fetuses with CHD and 40 controls. Read More

View Article and Full-Text PDF

A Novel Pulmonary Valve Replacement Surgery Strategy Using Contracting Band for Patients With Repaired Tetralogy of Fallot: An MRI-Based Multipatient Modeling Study.

Front Bioeng Biotechnol 2021 19;9:638934. Epub 2021 May 19.

School of Biological Science and Medical Engineering, Southeast University, Nanjing, China.

Patients with repaired Tetralogy of Fallot (ToF), a congenital heart defect which includes a ventricular septal defect and severe right ventricular outflow obstruction, account for the majority of cases with late-onset right ventricle (RV) failure. Current surgery procedures, including pulmonary valve replacement (PVR) with right ventricle remodeling, yield mixed results. PVR with active band insertion was hypothesized to be of clinical usage on improving RV function measured by ejection fraction (EF). Read More

View Article and Full-Text PDF

Dexmedetomidine Protects Human Cardiomyocytes Against Ischemia-Reperfusion Injury Through α2-Adrenergic Receptor/AMPK-Dependent Autophagy.

Front Pharmacol 2021 21;12:615424. Epub 2021 May 21.

Department of Thoracic and Cardiovascular Surgery, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiaotong University, Shanghai, China.

Ischemia-reperfusion injury (I/R) strongly affects the prognosis of children with complicated congenital heart diseases (CHDs) who undergo long-term cardiac surgical processes. Recently, the α2-adrenergic receptor agonist (Dex) has been reported to protect cardiomyocytes (CMs) from I/R in cellular models and adult rodent models. However, whether and how Dex may protect human CMs in young children remains largely unknown. Read More

View Article and Full-Text PDF

Absent pulmonary valve with tricuspid atresia/stenosis: literature review with new three long-term cases.

Heart Vessels 2021 Jun 5. Epub 2021 Jun 5.

Department of Pediatric Cardiology, Osaka City General Hospital, Osaka, Japan.

Absent pulmonary valve (APV) syndrome with tricuspid atresia or tricuspid stenosis (TA/TS) is an extremely rare malformation recently reported as a variant of APV with intact ventricular septum (VS). The condition, however, has univentricular physiology and unique structural and clinical features. The purpose of this study was to update the current knowledge about this condition by describing long-term outcomes of three new cases and reviewing the available literatures. Read More

View Article and Full-Text PDF

A case of -negative early gastric adenocarcinoma with gastrointestinal phenotype.

Endosc Int Open 2021 Jun 27;9(6):E863-E866. Epub 2021 May 27.

Division of Gastroenterology and Hepatology, Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan.

A 40-year-old man with slightly depressed (0-IIc) type gastric cancer of the pyloric anterior gastric area underwent pre-operative screening for tetralogy of Fallot and endoscopic submucosal dissection (ESD) and was tested for antigens and antibodies. Both tests were negative. He did not have a history of eradication. Read More

View Article and Full-Text PDF

Circulation derived from 4D flow MRI correlates with right ventricular dysfunction in patients with tetralogy of Fallot.

Sci Rep 2021 Jun 2;11(1):11623. Epub 2021 Jun 2.

Department of Diagnostic Imaging and Nuclear Medicine, Tokyo Women's Medical University, 8-1 Wakamatsu Kawada, Tokyo, 1628666, Japan.

We used 4D-flow MRI to investigate circulation, an area integral of vorticity, in the main pulmonary artery (MPA) as a new hemodynamic parameter for assessing patients with a repaired Tetralogy of Fallot (TOF). We evaluated the relationship between circulation, right ventricular (RV) function and the pulmonary regurgitant fraction (PRF). Twenty patients with a repaired TOF underwent cardiac MRI. Read More

View Article and Full-Text PDF

Preoperative Morphological Prediction of Early Reoperation Risk After Primary Repair in Tetralogy of Fallot: A Contemporary Analysis of 83 Cases.

Pediatr Cardiol 2021 Jun 1. Epub 2021 Jun 1.

Department of Cardiothoracic Surgery, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, 1678 Dongfang Rd., Shanghai, 200127, China.

This study was conducted to investigate the pulmonary artery (PA) variations in tetralogy of Fallot (TOF) and preoperative morphological predictors for early reoperation. Eighty-three TOF patients and 20 children with normal PA were included. The TOF group was divided into two subsets according to whether or not reoperation was performed within 3 years postoperatively. Read More

View Article and Full-Text PDF

Tracheal trifurcation: new cases and review of the literature.

Pediatr Radiol 2021 May 28. Epub 2021 May 28.

Advanced Cardiovascular Imaging Unit-Department of Imaging, Bambino Gesù Children's Hospital, IRCCS, Rome, RM, Italy.

Background: Tracheal trifurcation is an uncommon and often unknown type of anomalous tracheobronchial arborization, characterized by three main bronchi originating at the level of the carina. Diagnosis is important due to its clinical implications.

Objective: To highlight the anatomical, clinical and diagnostic aspects of tracheal trifurcation by reporting our experience and reviewing the literature. Read More

View Article and Full-Text PDF

Utility of a modified vascular corrosion casting technique in the diagnosis of fetal total anomalous pulmonary venous connection.

Sci Rep 2021 May 28;11(1):11281. Epub 2021 May 28.

Department of Ultrasound, Xiangyang No. 1 People's Hospital, Hubei University of Medicine, 15 Jiefang Avenue, Xiangyang, 441000, Hubei, China.

Total anomalous pulmonary venous connection (TAPVC) is a rare congenital cardiac malformation, and prenatal detection of TAPVC malformation remains a challenging. TAPVC can be easily missed or misdiagnosed in prenatal examinations. This study was aimed to use the modified vascular corrosion casting technique to prepare fetal cardiovascular casts with TAPVC and investigate the utility of cardiovascular casting for the demonstration of fetal TAPVC. Read More

View Article and Full-Text PDF

Impaired right and left ventricular function and relaxation induced by pulmonary regurgitation are not reversed by tardive anti-fibrosis treatment.

Am J Physiol Heart Circ Physiol 2021 May 28. Epub 2021 May 28.

Division of Cardiology, Labatt Family Heart Centre, Hospital for Sick Children, Toronto, Ontario, Canada.

Pulmonary regurgitation (PR) after repair of tetralogy of Fallot (TOF) is associated with progressive right (RV) and left (LV) ventricular dysfunction and fibrosis. However, angiotensin Ⅱ receptor blockade therapy has shown mixed and often disappointing results. The aim of this study was to serially assess changes in biventricular remodeling, dysfunction and interactions in a rat model of isolated severe PR and to study the effects of angiotensin Ⅱ receptor blockade. Read More

View Article and Full-Text PDF

Evolution of echocardiography in adult congenital heart disease: from pulsed-wave Doppler to fusion imaging.

J Echocardiogr 2021 May 28. Epub 2021 May 28.

Department of Cardiovascular Medicine, Adult Congenital Heart Disease Center, Okayama University Hospital, 2-5-1, Shikata-Cho, Kita-ku, Okayama City, Okayama, 700-8558, Japan.

The number of patients with adult congenital heart disease (ACHD) has been dramatically increasing and adults with congenital heart disease now outnumber children with congenital heart disease. However, patients with ACHD are still at increased risk of morbidity and mortality due to residua and sequelae. Although echocardiography is an indispensable imaging modality in the comprehensive assessment of ACHD, accurate echocardiographic assessment of ACHD is challenging especially for physicians or sonographers who are not familiar with ACHD because of its complex morphology, physiology, and hemodynamics. Read More

View Article and Full-Text PDF

Is a Hub lncRNA ceRNA in Hearts With Tetralogy of Fallot Which Regulates Congenital Heart Disease Genes Transcriptionally and Epigenetically.

Front Cell Dev Biol 2021 11;9:630634. Epub 2021 May 11.

Cardiac Intensive Care Unit, Department of Thoracic and Cardiovascular Surgery, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China.

Heart development requires robust gene regulation, and the related disruption could lead to congenital heart disease (CHD). To gain insights into the regulation of gene expression in CHD, we obtained the expression profiles of long non-coding RNAs (lncRNAs) and messenger RNAs (mRNAs) in 22 heart tissue samples with tetralogy of Fallot (TOF) through strand-specific transcriptomic analysis. Using a causal inference framework based on the expression correlations and validated microRNA (miRNA)-lncRNA-mRNA evidences, we constructed the competing endogenous RNA (ceRNA)-mediated network driven by lncRNAs. Read More

View Article and Full-Text PDF

Laparoscopic-Assisted Percutaneous Endoscopic Gastrostomy Reduces Major Complications in High-Risk Pediatric Patients.

Pediatr Gastroenterol Hepatol Nutr 2021 May 4;24(3):273-278. Epub 2021 May 4.

Division of Surgery, Department of Pediatrics, University of Szeged, Szeged, Hungary.

Purpose: Percutaneous endoscopic gastrostomy (PEG) is a safe method to feed patients with feeding difficulty. This study aimed to compare the outcomes of conventional PEG and laparoscopic-assisted PEG (L-PEG) placement in high-risk pediatric patients.

Methods: In our tertiary pediatric department, 90 PEG insertions were performed between 2014 and 2019. Read More

View Article and Full-Text PDF

Exercise training in patients with corrected tetralogy of Fallot: A protocol for systematic review and meta-analysis.

Medicine (Baltimore) 2021 May;100(21):e26108

Department of Cardiovascular Surgery, Gansu Provincial Hospital.

Background: The arrival of transcatheter mitral valve therapies has provided feasible and safe alternatives to medical and surgical treatments for mitral regurgitation. The aim of this study is to estimate the relative efficacy and safety of exercise training in patients with corrected tetralogy of Fallot through meta-analysis.

Methods: : A systematic search will be performed using PubMed, EMBASE, the Cochrane Library, Web of Science, CBM, CNKI, WanFang Data, and VIP to include random controlled trials or nonrandom controlled trials comparing the efficacy and safety of exercise training in corrected tetralogy of Fallot patients. Read More

View Article and Full-Text PDF

Prenatal diagnosis, associated findings and postnatal outcome of fetuses with truncus arteriosus communis (TAC).

Arch Gynecol Obstet 2021 May 24. Epub 2021 May 24.

Division of Prenatal Medicine, Department of Obstetrics and Gynecology, University of Cologne, Kerpenerstr. 34, 50931, Cologne, Germany.

Purpose: To assess the spectrum of associated anomalies, the intrauterine course, postnatal outcome and management of fetuses with truncus arteriosus communis (TAC) METHODS: All cases of TAC diagnosed prenatally over a period of 8 years were retrospectively collected in two tertiary referral centers. All additional prenatal findings were assessed and correlated with the outcome. The accuracy of prenatal diagnosis was assessed. Read More

View Article and Full-Text PDF

Surgical versus transcatheter palliation for insufficient pulmonary blood supply in infants with cyanotic CHD.

Cardiol Young 2021 May 24:1-6. Epub 2021 May 24.

Congenital Cardiology, Leeds General Infirmary, Great George Street, Leeds, United Kingdom.

Infants with complex cyanotic CHD can become symptomatic from insufficient pulmonary blood supply following either ductal closure or due to outflow tract obstruction. Blalock-Taussig shunt mortality remains significant and recent studies have highlighted the advantages of using transcatheter alternatives. We present here our experience in changing our primary choice of palliation from the Blalock-Taussig shunt to transcatheter palliation with either a ductal stent or, if antegrade flow is present, a right ventricular outflow tract stent. Read More

View Article and Full-Text PDF

The Role of Ablation in Prevention of Recurrent Implantable Cardioverter Defibrillator Shocks in Patients With Tetralogy of Fallot.

CJC Open 2021 May 28;3(5):619-626. Epub 2021 Jan 28.

University Health Network Toronto, Peter Munk Cardiac Centre, and University of Toronto, Toronto, Ontario, Canada.

Background: Implantable cardioverter defibrillators (ICDs) are effective in preventing arrhythmic sudden cardiac death in patients with tetralogy of Fallot (TOF). Although ICD therapies for malignant ventricular arrhythmias can be life-saving, shocks could have deleterious consequences. Substrate-based ablation therapy has become the standard of care to prevent recurrent ICD shocks in patients with ischemic cardiomyopathy. Read More

View Article and Full-Text PDF

Case report of recurrent haemoptysis in an older patient with repaired tetralogy of Fallot.

Eur Heart J Case Rep 2021 May 17;5(5):ytab155. Epub 2021 May 17.

Department of Cardiovascular Diseases, Division of Congenital and Structural Cardiology, University Hospitals Leuven, Herestraat 49, 3000 Leuven, Belgium.

Background: Tetralogy of Fallot (TOF) is the most common cyanotic congenital heart defect. Although most infants nowadays undergo surgical repair approximately at the age of 6 months with excellent outcomes, older patients typically underwent a staged approach with an initial systemic-to-pulmonary Blalock-Taussig-Thomas (BTT) shunt reducing hypoxaemia, followed by surgical TOF repair at an older age (with takedown of the BTT shunt). Late complications related to the BTT shunt are rare. Read More

View Article and Full-Text PDF

Follow-up aortic dilatation in patients with repaired tetralogy of Fallot using cardiovascular magnetic resonance.

Eur J Radiol Open 2021 12;8:100354. Epub 2021 May 12.

Division of Cardiology, Department of Pediatrics, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, 270 Rama 6 Road, Phayatai, Ratchathewi, Bangkok, 10400, Thailand.

Purpose: The study sought to determine the rate of aortic expansion and correlation with somatic growth in patients with repaired tetralogy of Fallot (rTOF), and predictors for determining the annual growth rate of the aorta (Ao-AGR).

Methods: Ninety-four rTOF patients (mean age 14.5 ± 4. Read More

View Article and Full-Text PDF