scholarly journals Arrhythmias in repaired pediatric and adolescent Fallot tetralogy, correlation with cardiac MRI parameters

2021 ◽  
Vol 52 (1) ◽  
Author(s):  
Samira Saraya ◽  
Ahmed Ramadan ◽  
Antoine AbdelMassih ◽  
Gehan Hussein ◽  
Fatma Al zahraa Mostafa ◽  
...  
Keyword(s):  
Right Ventricular ◽  
Cardiac Mri ◽  
Surgical Repair ◽  
Pulmonary Regurgitation ◽  
Ventricular Dilatation ◽  
Volume Index ◽  
Cross Sectional ◽  
Transthoracic Doppler Echocardiography ◽  
Significant Difference ◽  
Right Ventricular Dilatation

Abstract Background Tetralogy of Fallot (TOF) is a common congenital cyanotic heart disease in which arrhythmias could develop even after successful operative repair. Pulmonary regurgitation and right ventricular dilatation develop in many cases. The relation between arrhythmias and right ventricular dilatation is not established. Our aim is to assess the relation in between the degree of right ventricular volume affection and the severity of the pulmonary regurgitation, associated arrhythmias and the need for pulmonary valve repair in Egyptian pediatric and adolescent cases after successful TOF repair. Results A cross sectional descriptive study was conducted on 32 cases after successful surgical repair. Transthoracic Doppler echocardiography, 24 h Holter monitoring and cardiac MRI for assessment of pulmonary regurgitation fraction (PRF), ventricular volumes and function were measured. Cases were classified according to right ventricular end diastolic volume index (RVEDVI) into 2 groups with cut off value 150 ml/m2. Mean age of the studied cases was (12.96 ± 3.384) years, mean age at time of surgical repair was (34.23 ± 22.1) months, and mean duration postoperatively was (121.72 ± 41.028) months. Eighteen cases (56%) had RVEDVI ≥ 150 ml/m2, PRF was significantly higher in cases with increased RVEDVI (p value 0.007), with positive significant correlation between RVEDVI and PRF (p value = 0.0001, r = 0.61). Arrhythmias were detected in 18 cases (56%), the most common of which was infrequent supraventricular ectopy. No significant difference in incidence of arrhythmias between the 2 groups (p value = 1) with also no significant correlation between arrhythmias and increased RVEDVI (p value = 0.76, r = 0.05). No difference between cases with and without arrhythmias regarding RVEDVI (p value = 0.56) or PRF (p value = 0.5). Conclusion Holter detected arrhythmias after successful surgical repair of TOF were significantly associated with increased postoperative duration but not with PRF or RVEDVI.

scholarly journals NT-proBNP as a biomarker of right ventricular dilatation and pulmonary regurgitation in Tetralogy of Fallot

2015 ◽  
Vol 17 (S1) ◽  
Author(s):  
Israel Valverde ◽  
Annalisa Paolino ◽  
Maria Pilar Serrano Gotarredona ◽  
Silvia Navarro ◽  
Nieves Romero ◽  
...  
Keyword(s):  
Right Ventricular ◽  
Tetralogy Of Fallot ◽  
Pulmonary Regurgitation ◽  
Ventricular Dilatation ◽  
Right Ventricular Dilatation

scholarly journals Progress of right ventricular dilatation in adults with repaired tetralogy of Fallot and free pulmonary regurgitation

2014 ◽  
Vol 3 ◽  
pp. 28-31 ◽  
Author(s):  
Shamus O’Meagher ◽  
Madhusudan Ganigara ◽  
David J. Tanous ◽  
David S. Celermajer ◽  
Rajesh Puranik
Keyword(s):  
Right Ventricular ◽  
Tetralogy Of Fallot ◽  
Pulmonary Regurgitation ◽  
Ventricular Dilatation ◽  
Repaired Tetralogy Of Fallot ◽  
Right Ventricular Dilatation

Surgically treated pulmonary stenosis: over 50 years of follow-up

2015 ◽  
Vol 26 (5) ◽  
pp. 860-866 ◽  
Author(s):  
Eva A. Nielsen ◽  
Vibeke E. Hjortdal
Keyword(s):  
Right Ventricular ◽  
Valve Replacement ◽  
Tricuspid Regurgitation ◽  
Pulmonary Valve ◽  
Pulmonary Stenosis ◽  
Pulmonary Regurgitation ◽  
Pulmonary Valve Replacement ◽  
Ventricular Dilatation ◽  
Right Ventricular Dilatation

AbstractBackgroundSurgical correction was the treatment of choice for pulmonary stenosis until three decades ago, when balloon valvuloplasty was implemented. The natural history of surgically relieved pulmonary stenosis has been considered benign but is actually unknown, as is the need for re-intervention.The objective of this study was to investigate the morbidity and mortality of patients with surgically treated pulmonary stenosis operated at Aarhus University Hospital between 1957 and 2000.ResultsThe total study population included 80 patients. In-hospital mortality was 2/80 (2.5%), and an additional four patients died after hospital discharge; therefore, the long-term mortality was 5%. The maximum follow-up period was 57 years, with a median of 33 years. In all, 16 patients (20%) required at least one re-intervention. Pulmonary valve replacement due to pulmonary regurgitation was the most common re-intervention (67%). Freedom from re-intervention decreased >20 years after the initial repair. In addition, 45% of patients had moderate/severe pulmonary regurgitation, 38% had some degree of right ventricular dilatation, and 40% had some degree of tricuspid regurgitation, which did not require re-intervention at the present stage.ConclusionSurgical relief for pulmonary stenosis is efficient in relieving outflow obstruction; however, this efficiency is achieved at the cost of pulmonary regurgitation, leading to right ventricular dilatation and tricuspid regurgitation. When required, pulmonary valve replacement is performed most frequently >20 years after the initial surgery. Lifelong follow-up of patients treated surgically for pulmonary stenosis is emphasised in this group of patients, who might otherwise consider themselves cured.

scholarly journals Right ventricular dilatation in patients with pulmonary regurgitation after repair of tetralogy of Fallot: How fast does it progress?

2020 ◽  
Vol 13 (4) ◽  
pp. 294
Author(s):  
Martin Hoelscher ◽  
Francesca Bonassin ◽  
Angela Oxenius ◽  
Burkhart Seifert ◽  
Benedetta Leonardi ◽  
...  
Keyword(s):  
Right Ventricular ◽  
Tetralogy Of Fallot ◽  
Pulmonary Regurgitation ◽  
Ventricular Dilatation ◽  
Right Ventricular Dilatation

scholarly journals Early postoperative remodelling following repair of tetralogy of Fallot utilising unsedated cardiac magnetic resonance: a pilot study

2018 ◽  
Vol 28 (5) ◽  
pp. 697-701 ◽  
Author(s):  
Michael P. DiLorenzo ◽  
Elizabeth Goldmuntz ◽  
Susan C. Nicolson ◽  
Mark A. Fogel ◽  
Laura Mercer-Rosa
Keyword(s):  
Right Ventricular ◽  
Tetralogy Of Fallot ◽  
Cardiac Mri ◽  
Surgical Repair ◽  
Pulmonary Regurgitation ◽  
Pulmonary Insufficiency ◽  
Ventricular Remodelling ◽  
Ventricular Ejection Fraction ◽  
End Diastolic Volume ◽  
Right Ventricular Mass

AbstractIntroductionThe right ventricular adaptations early after surgery in infants with tetralogy of Fallot are important to understand the changes that occur later on in life; this physiology has not been fully delineated. We sought to assess early postoperative right ventricular remodelling in patients with tetralogy of Fallot by cardiac MRI.Materials and methodSubjects with tetralogy of Fallot under 1 year of age were recruited following complete surgical repair for tetralogy of Fallot. Protocol-based cardiac MRI to assess anatomy, function, and flows was performed before hospital discharge using the feed and sleep technique, an unsedated imaging technique.ResultsMRI was completed in 16 subjects at a median age of 77 days (interquartile range 114). There was normal ventricular ejection fraction and indexed right ventricular end-diastolic volume (48±13 cc/m2), but elevated right ventricular mass (z score 6.2±2.4). Subjects requiring a transannular patch or right ventricle to pulmonary artery conduit had moderate pulmonary insufficiency (regurgitant fraction 27±16%).DiscussionEarly right ventricular remodelling after surgical repair for tetralogy of Fallot is characterised by significant pulmonary regurgitation, right ventricular hypertrophy, and lack of dilation. Performing cardiac MRI using the feed and sleep technique is feasible in infants younger than 5 months. These results might open new avenues to study longitudinal right ventricular changes in tetralogy of Fallot and to further explore the utility of unsedated MRI in patients with other types of CHDs.

scholarly journals Evaluation of the relationship between ventricular function and serum growth differentiation factor-15 levels in patients with operated tetralogy of Fallot

2021 ◽  
pp. 1-6
Author(s):  
Damla Önal ◽  
Ayşe G. Eroğlu ◽  
Nazlı G. Akyel ◽  
Esra K. Yüksel ◽  
Hasan Karakaş ◽  
...  
Keyword(s):  
Tetralogy Of Fallot ◽  
Cardiac Mri ◽  
Pulmonary Regurgitation ◽  
Volume Index ◽  
Healthy Children ◽  
Growth Differentiation Factor 15 ◽  
Systolic Volume ◽  
Differentiation Factor ◽  
Significant Difference ◽  
The Relationship

Abstract Aim: Growth differentiation factor-15 is a novel biomarker of increasing importance in cardiovascular diseases. This study aimed to evaluate the relationship between ventricular measurements assessed by cardiac magnetic resonance imaging (MRI) and serum growth differentiation factor-15 levels in children with surgically corrected tetralogy of Fallot. Materials and method: Serum growth differentiation factor-15 levels were measured in 40 patients (mean age: 15.2 ± 2.9 years; 52.5% male; 87.5% NYHA I). End-diastolic volume index, end-systolic volume index, and ejection fractions of both ventricles and pulmonary regurgitation fraction were measured on cardiac MRI. The correlation between growth differentiation factor-15 levels and cardiac MRI parameters of the patients was investigated. Also, growth differentiation factor-15 levels of the patients were compared with healthy controls since reference values have not been determined in children. Results: The mean growth differentiation factor-15 level was 254.9 ± 6.3 pg/ml in the patient group. There was no correlation between growth differentiation factor-15 levels and cardiac MRI parameters in patients. Also, there was no significant difference in growth differentiation factor-15 levels between the patients and control groups. Conclusion: The serum levels of growth differentiation factor-15 were uncorrelated with ventricular size, function, and pulmonary regurgitation fraction assessed by cardiac MRI in children with operated tetralogy of Fallot. Moreover, growth differentiation factor-15 levels were not different in these patients from healthy children.

scholarly journals Pacemaker lead-associated tricuspid regurgitation in patients with or without pre-existing right ventricular dilatation

2021 ◽  
Author(s):  
Martin Riesenhuber ◽  
Andreas Spannbauer ◽  
Marianne Gwechenberger ◽  
Thomas Pezawas ◽  
Christoph Schukro ◽  
...  
Keyword(s):  
Mitral Regurgitation ◽  
Right Ventricular ◽  
Tricuspid Regurgitation ◽  
Pacemaker Implantation ◽  
Ventricular Dilatation ◽  
Pacemaker Lead ◽  
Survival Analyses ◽  
Before And After ◽  
Right Ventricular Dilatation ◽  
Survival Predictors

Abstract Background Transcatheter tricuspid valve intervention became an option for pacemaker lead-associated tricuspid regurgitation. This study investigated the progression of tricuspid regurgitation (TR) in patients with or without pre-existing right ventricular dilatation (RVD) undergoing pacemaker implantation. Methods Patients were included if they had implantation of transtricuspid pacemaker lead and completed echocardiography before and after implantation. The cohort was divided in patients with and without RVD (cut-off basal RV diameter ≥ 42 mm). TR was graded in none/mild, moderate, and severe. Worsening of one grade was defined as progression. Survival analyses were plotted for 10 years. Results In total, 990 patients were analyzed (24.5% with RVD). Progression of TR occurred in 46.1% of patients with RVD and in 25.6% of patients without RVD (P < 0.001). Predictors for TR progression were RV dilatation (OR 2.04; 95% CI 1.27–3.29; P = 0.003), pre-existing TR (OR 4.30; 95% CI 2.51–7.38; P < 0.001), female sex (OR 1.68; 95% CI 1.16–2.43; P = 0.006), single RV lead (OR 1.67; 95% CI 1.09–2.56; P = 0.018), mitral regurgitation (OR 2.08; 95% CI 1.42–3.05; P < 0.001), and enlarged left atrium (OR 1.98; 95% CI 1.07–3.67; P = 0.03). Survival-predictors were pacemaker lead-associated TR (HR 1.38; 95% CI 1.04–1.84; P = 0.028), mitral regurgitation (HR 1.34; 95% CI 1.02–1.77; P = 0.034), heart failure (HR 1.75; 95% CI 1.31–2.33; P < 0.001), kidney disease (HR 1.62; 95% CI 1.25–2.11; P < 0.001), and age ≥ 80 years (HR 2.84; 95% CI 2.17–3.71; P < 0.001). Conclusions Patients with RVD receiving pacemaker suffered from increased TR progression, leading to decreased survival. Graphic abstract

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