Tetralogy of Fallot with Neurological Manisfistation

JMS SKIMS ◽  
2009 ◽  
Vol 12 (1) ◽  
pp. 18-20
Author(s):  
R K Kotokey ◽  
Swarup Kar ◽  
Arup Sharma ◽  
Libe Nyorak ◽  
S Rupshi ◽  
...  
Keyword(s):  
Tetralogy Of Fallot ◽  
Heart Diseases ◽  
Pulmonary Stenosis ◽  
Term Survival ◽  
North East ◽  
Fallot's Tetralogy ◽  
Fallot’S Tetralogy ◽  
Brain Abscesses ◽  
Cyanotic Congenital Heart Diseases

Fallot's Tetralogy is one of the most common cyanotic congenital heart diseases. Most of the patients though die during adulthood (depending upon the severity of pulmonary stenosis) but long term survival has also been recorded in the literature. Though there are various complications of Tetralogy of Fallot; multiple brain abscesses as a sequele of Fallot's Tetralogy leading to neurological manifestations is not frequently encountered in this part of North East. A case of Fallot's Tetralogy presenting with severe neurological deficit due to multiple brain abscesses who was treated conservatively is presented. The patient responded to the conservative management. (.1MedSci 2009;12(1):18-20)

Absence of the arterial duct in a neonate with tricuspid atresia

1994 ◽  
Vol 4 (2) ◽  
pp. 187-189
Author(s):  
Beth Bubolz ◽  
Christopher L. Case ◽  
Robert M. Sade
Keyword(s):  
Aortic Arch ◽  
Tetralogy Of Fallot ◽  
Congenital Heart ◽  
Clinical Course ◽  
Heart Diseases ◽  
Pulmonary Stenosis ◽  
Tricuspid Atresia ◽  
Congenital Heart Diseases ◽  
Arterial Duct ◽  
Cyanotic Congenital Heart Diseases

SummarySummary Absence of the arterial duct has been reported in association with tetralogy of Fallot, with pulmonary stenosis or atresia, other complex cyanotic congenital heart diseases, and anomalies of the aortic arch but not, as far as we are aware, with tricuspid atresia. We report the clinical, surgical, and autopsy findings of a patient with tricuspid atresia whose initial clinical course was influenced by the absence of thearterial duct.

Brain Abscesses: An Overview in Children

2017 ◽  
Vol 14 (01) ◽  
pp. 002-005 ◽  
Author(s):  
Paola Zangari ◽  
Maia De Luca ◽  
Alberto Villani ◽  
Andrzej Krzysztofiak
Keyword(s):  
Heart Diseases ◽  
Predisposing Factors ◽  
Older Children ◽  
The Past ◽  
Life Threatening ◽  
Ear Infections ◽  
Brain Abscesses ◽  
Cyanotic Congenital Heart Diseases ◽  
Disease Specialist

AbstractBrain abscesses in infants and children might be life threatening if not managed properly. They occur more frequently in the first two decades of life despite the reduced incidence of sinus and ear infections in pediatrics. The features of brain abscess in terms of location, pathogens, and symptoms depend on age and thus on predisposing factors. In infants and toddlers, bacterial meningitis or bacteremia is the major cause, and in older children, immunosuppression and cyanotic congenital heart diseases are common predisposing factors. The therapeutic management of brain abscesses involves a multidisciplinary team, including infectious disease specialist, neurosurgery, neuroradiology, and neurology. A prompt and long-term antimicrobial therapy is the mainstay of treatment, often associated with surgical drainage. These changes in the management have significantly improved the prognosis of patients with brain abscesses over the past 50 years.

scholarly journals The role of MDCT in the assessment of cardiac and extra-cardiac vascular defects among Egyptian children with tetralogy of Fallot and its surgical implementation

2021 ◽  
Vol 52 (1) ◽  
Author(s):  
Ahmed Elshimy ◽  
Rasha Tolba Khattab ◽  
Hend Galal Eldeen Mohamed Ali Hassan
Keyword(s):  
Tetralogy Of Fallot ◽  
Heart Diseases ◽  
Preoperative Evaluation ◽  
Vena Cava ◽  
Predictive Values ◽  
Surgical Interventions ◽  
Vascular Abnormalities ◽  
Egyptian Children ◽  
Cardiac Lesions ◽  
Cyanotic Congenital Heart Diseases

Abstract Background Tetralogy of Fallot (TOF) is considered the most common form of cyanotic congenital heart diseases (CHD), accounting for about 10% of cases. It includes four main cardiac defects, in addition to various extra-cardiac anomalies. Aim This study aimed to evaluate cardiac and extra-cardiac vascular defects associated with TOF among Egyptian children, regarding frequency and types with assessment of multi-slice or multi-detector computed tomography (MDCT) role in their diagnosis. Definitely, full detection of these vascular anomalies has utmost importance when evaluating such patients particularly before surgical intervention. Methods This study included 60 pediatric patients diagnosed as TOF, who underwent MDCT examination in our institute during period of 6 months from (March to September 2020), to confirm their trans-thoracic echocardiography (TTE) findings and detect other vascular abnormalities which cannot be precisely detected with TTE before their surgical interventions. Results The incidence of different extra-cardiac vascular defects diagnosed by MDCT among our patients was 85% which was significantly higher than that detected by TTE (55%). Moreover, MDCT was superior to TTE assessment as regards its diagnostic accuracy (96.6% vs. 80%), sensitivity (98% vs. 76.9%), and specificity (88.9% vs. 85.7%), in addition to both positive and negative predictive values. The most common anomalies detected were affecting the pulmonary artery (80%), followed by aorto-pulmonary vessels (45%), then aortic artery (40%), coronary arteries (20%), and lastly vena cava connection (6.7%). Patients’ demographic characteristics and clinical presentations were also presented. Conclusion This study confirmed that many extra-cardiac vascular defects are commonly associating cardiac lesions in TOF and emphasizing the great value of MDCT in their diagnosis. Certainly, proper detection of these anomalies will help decision-making during preoperative evaluation, corrective interventions, and further management of these cases.

scholarly journals Mid- to long-term follow-up of pulmonary valve replacement with BioIntegral injectable valve

2020 ◽  
Author(s):  
Simone Ghiselli ◽  
Cristina Carro ◽  
Nicola Uricchio ◽  
Giuseppe Annoni ◽  
Stefano M Marianeschi
Keyword(s):  
Cardiopulmonary Bypass ◽  
Right Ventricular ◽  
Tetralogy Of Fallot ◽  
Valve Replacement ◽  
Pulmonary Valve ◽  
Pulmonary Stenosis ◽  
Pulmonary Regurgitation ◽  
Pulmonary Valve Replacement

Abstract OBJECTIVES Chronic pulmonary valve (PV) regurgitation is a common late sequela after repair of congenital heart diseases like tetralogy of Fallot or pulmonary stenosis, leading to right ventricular dilatation and failure and increased late morbidity and mortality. Timely reoperation may lead to a complete right ventricular recovery. An injectable PV allows pulmonary valve replacement, with or without cardiopulmonary bypass, under direct observation, thereby minimizing the impact of surgery on cardiac function. The aim of this study was to evaluate the feasibility and mid- to long-term clinical outcomes with this device. METHODS From April 2007 to October 2019, a total of 85 symptomatic patients with severe pulmonary regurgitation or pulmonary stenosis underwent pulmonary valve replacement with an injectable stented pulmonary prosthesis. Data were collected from the international proctoring registry. Mean patient age was 26.7 years. The underlying diagnosis was repaired tetralogy of Fallot in 69.4% patients; moderate or severe pulmonary regurgitation was present in 72.9%. All patients had echocardiographic scans before the operation and during the follow-up period. A total of 54.1% patients also had preoperative/postoperative cardiac magnetic resonance imaging (MRI) or catheterization; 25.9% had off-pump implants. In 53% patients, pulmonary valve replacement was associated with the repair of other cardiac defects. RESULTS Minor postoperative complications were observed in 10.8% patients. The overall mortality rate was 2.3%; mortality after valve replacement was linked to a severe cardiac insufficiency and it was not related to a prosthesis failure; 1 prosthesis was explanted from 1 patient because of endocarditis, and 6% of patients developed PV stenosis; minor complications occurred in 4.8%. The mean follow-up period was 4.8 years (2 months–12.7 years); 42% of the patients were followed for more than 5 years. Follow-up echocardiography and cardiac MRI showed a significant reduction in RV size and low gradients across the PV. CONCLUSIONS An injectable PV may be implanted without cardiopulmonary bypass and in a hybrid operating theatre with minimal surgical impact. The bioprosthesis, available up to large sizes, has a low profile, laminar flow and no risk of coronary artery compression. Incidence of endocarditis is rare. The lack of a suture ring permits the implant of a relatively larger prosthesis, thereby avoiding a right ventricular outflow tract obstruction. This device permits future percutaneous valve-in-valve procedures, if needed. Results concerning durability are encouraging, and mid- to long-term haemodynamic performance is excellent.

scholarly journals Outcomes after corrective surgery for congenital dextro-transposition of the arteries using the arterial switch technique: a scoping systematic review

2020 ◽  
Vol 9 (1) ◽  
Author(s):  
Frederick Morfaw ◽  
Alvin Leenus ◽  
Lawrence Mbuagbaw ◽  
Laura N. Anderson ◽  
Rejane Dillenburg ◽  
...  
Keyword(s):  
Arterial Switch Operation ◽  
Meta Analysis ◽  
Pulmonary Stenosis ◽  
Medium Term ◽  
Term Survival ◽  
Neuropsychological Development ◽  
Arterial Switch ◽  
Pooled Data ◽  
Secondary Outcomes

Abstract Background Dextro-transposition of the great arteries (d-TGA) is the most frequent cyanotic congenital heart pathology in neonates. Surgical correction of this condition is possible using the arterial switch operation (ASO) which was first performed by Jatene in 1975. Objectives The aim of this study was to summarise the evidence on short- (less than 1 year), medium- (1–20 years), and long-term (more than 20 years) outcomes of children with d-TGA treated with the ASO. The primary outcome was survival. Secondary outcomes were freedom from cardiac reoperations, occurrence of aortic insufficiency, pulmonary stenosis, coronary artery anomalies, neuropsychological development problems and quality of life. Methods We searched MEDLINE, EMBASE, CINAHL, LILACS, and reference lists of included articles for studies reporting outcomes after ASO for d-TGA. Screening, data extraction and risk of bias assessment were done independently by two reviewers. We pooled data using a random-effects meta-analysis of proportions and, where not possible, outcomes were synthesized narratively. We used the Grading of Recommendations Assessment, Development and Evaluation (GRADE) system to assess the certainty of the evidence for each outcome. Main results Following ASO for TGA, short-term survival was 92.0% (95% CI 91.0–93.0%; I2 = 85.8%, 151 studies, 30,186 participants; moderate certainty evidence). Medium-term survival was 90.0% (95% CI 89.0–91.0%; I2 = 84.3%, 133 studies; 23,686 participants, moderate certainty evidence), while long-term survival was 87.0% (95% CI 80.0–92.0 %; I2 = 84.5%, 4 studies, 933 participants, very low certainty evidence). Evaluation of the different secondary outcomes also showed satisfactory results in the short, medium and long term. Subgroup analysis suggests slightly higher survival following ASO for TGA in the second surgical era (1998 to 2018) than in the first surgical era (1975 to 1997) in the short and medium term [93.0% (95% CI 92.0–94.0) vs 90.0% (95% CI 89.0–92.0) and 93.0% (95% CI 91.0–94.0) vs 88.0% (87.0–90.0%) respectively] but not in the long term [81.0% (95% CI 76.0–86.0%) vs 89.0% (80.0–95.0%)]. Conclusions Pooled data from many sources suggests that the ASO for d-TGA leads to high rates of survival in the short, medium, and long term.

scholarly journals Determinants of long-term survival in tetralogy of fallot: 36 years follow-up in 447 first year survivors after repair

1996 ◽  
Vol 27 (2) ◽  
pp. 93
Author(s):  
Georg Nollert ◽  
Teddy Fischlein ◽  
Eckart Kreuzer ◽  
Armin Welz ◽  
Heinrich Netz ◽  
...  
Keyword(s):  
Tetralogy Of Fallot ◽  
First Year ◽  
Term Survival ◽  
Long Term Survival

scholarly journals Long-term treatment with propranolol in selected cases of Fallot's tetralogy.

Heart ◽  
1969 ◽  
Vol 31 (1) ◽  
pp. 37-44 ◽  
Author(s):  
B O Eriksson ◽  
C Thoren ◽  
P Zetterqvist
Keyword(s):  
Term Treatment ◽  
Fallot's Tetralogy ◽  
Long Term Treatment ◽  
Fallot’S Tetralogy

Repair of tetralogy of Fallot associated with atrioventricular septal defect

1998 ◽  
Vol 8 (1) ◽  
pp. 105-112 ◽  
Author(s):  
Tomás̆ Tláskal ◽  
Bohumil Huc̆ín ◽  
Martin Kostelka ◽  
Václav Chaloupecký ◽  
Jan Marek ◽  
...  
Keyword(s):  
Tetralogy Of Fallot ◽  
Septal Defect ◽  
Pulmonary Stenosis ◽  
Pulmonary Arteries ◽  
Pulmonary Regurgitation ◽  
Atrioventricular Septal Defect ◽  
Arterial Stenosis ◽  
Long Term Results

AbstractTetralogy of Fallot, when associated with atrioventricular septal defect permitting shunting at ventricular level, represents a complex cyanotic congenital malformation. Experience with surgical repair is limited, and results vary considerably. Between 1984 and 1996, we repaired 14 consecutive patients with this combination seen in our center. Their ages ranged from 8 months to 21 years (median 7.4 years). Six (42.9%) had Down's syndrome. In eight patients the correct diagnosis was made using echocardiogra phy alone. In the remaining six patients, who had previously-constructed arterial shunts and/or suspected pulmonary arterial stenosis, catheterization and angiocardiography were also performed. The repair consisted of double patch closure of the septal defect, reconstruction of two atrioventricular orifices, and relief of pulmonary stenosis at all levels. In five patients with a hypoplastic pulmonary trunk, a monocusp transannular patch (four patients) or an allograft (one patient) was used for restroration of continuity from the right ventricle to the pulmonary arteries. Patch enlargement of one or both pulmonary arteries was necessary in five patients. One patient (7.1%) died early, and another late. The twelve surviving (85.8%) patients have been followed for 1.2–12.5 years after surgery (median 4.9 years, mean 5.9 ± 3.9 years). During the follow-up, reoperation was necessary for repair of residual ventricular septal defect and pulmonary regurgitation in two patients, and closure of an atrial septal defect and alteration to left atrioventricular valvar regurgitation in one patient. Seven patients are in class I of the New York Heart Association, four in class II, and one in class III. Tetralogy of Fallot associated with atrioventricular septal defect can be corrected with low mortality and good long-term results. Residual lesions, however, have a tendency to progress, especially when seen in combination. After surgery, all patients need long-term close follow-up.

scholarly journals The tonkin snub-nosed monkey Rhinopithecus avunculus population in the Quan Ba forest, north-east Vietnam: an identification of priority habitat for conservation

2019 ◽  
Vol 41 (3) ◽  
Author(s):  
Nguyen Xuan Dang ◽  
Nguyen Xuan Nghia ◽  
Pham Van The
Keyword(s):  
Conservation Area ◽  
Forest Patch ◽  
Term Survival ◽  
Forest Farming ◽  
North East ◽  
Broad Leaved Forest ◽  
Priority Habitat ◽  
The Hill ◽  
Leaved Forest

The Tonkin Snub-nosed Monkey Rhinopithecus avunculus is among the World’s 25 most endangered primates. At present, the species is found only in few forest areas in Ha Giang and Tuyen Quang Provinces, north-east Vietnam with a total number not exceeding 250 individuals.  The forest block in Cao Ma Po, Ta Van and Tung Vai Communes of Quan Ba District, Ha Giang Province (the Cao - Ta - Tung forest) harbors the second largest population of Tonkin Snub-nosed Monkey. This population was estimated to be conisted of about 30–35 individuals in 2007.  However, it faces a number of serious threats (wildlife hunting, habitat degradation by widespread forest farming of Tsao-ko cardamom plant, etc.) that may lead the population to be extinct in near future. The population was reduced to 15–21 individuals in 2016 due to these threats. In 2017–2018, we conducted a study to identify a priority habitat area to establish the Quan Ba Tonkin Snub-nosed Monkey Conservation Area. The results of our study show that the distribution of  the Quan Ba Tonkin Snub-nosed Monkey  population is  confined to a small area (about 5,000 ha) belonging to the Theng Chu Phin, Dao Dan Chai, Ta Lay mountains, the Hill 754 and a forest patch along the Vietnam-China  border  from the Post 283  to Post 295. This area harbors the best forest of the Cao - Ta - Tung area. The forest covers 92.3% of the area, and only 7.7% of the area is a non-forest land. There are two types of forest: evergreen broad-leaved forest (50.0% of total area) and limestone evergreen broad-leaved forest (42.3%).  The evergreen broad-leaved forest has been degraded to medium and restoration status. Tsao-ko cardamom Amomum tsao-ko fields are widespread. The limestone evergreen broad-leaved forest of almost primary status remains in very steep slopes and limestone mountains. The Cao - Ta - Tung forest was designated as a watershed protection forest that allows farming of agricultural and medicinal plants inside the forest and the forest farming of Tsao-ko cardamom is widespread becoming the most serious threat to the long-term survival of the Tonkin Snub-nosed Monkey population. In order to ensure long-term survival of the Quan Ba Tonkin Snub-nosed Monkey population, the  area of the Theng Chu Pin, Dao Dai Chai, Ta Lay, Tung Lau mountains,  the Hill 754 and a forest patch along the Vietnam-China border from the Post 283 to Post 285 must be designated as a special-use forest, i.e. to establish a Quan Ba Tonkin Snub-nosed Monkey Conservation Area. 

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