scholarly journals Short-Term Change of Exercise Capacity in Patients with Pulmonary Valve Replacement after Tetralogy of Fallot Repair

2017 ◽  
Vol 47 (2) ◽  
pp. 254 ◽  
Author(s):  
Tae Woong Hwang ◽  
Sung Ook Kim ◽  
Moon Sun Kim ◽  
So Ick Jang ◽  
Seong Ho Kim ◽  
...  
Keyword(s):  
Tetralogy Of Fallot ◽  
Valve Replacement ◽  
Exercise Capacity ◽  
Pulmonary Valve ◽  
Pulmonary Valve Replacement ◽  
Short Term ◽  
Short Term Change ◽  
Term Change ◽  
Tetralogy Of Fallot Repair

Does transatrial-transpulmonary approach improve outcomes compared with transventricular approach in non-neonatal patients undergoing tetralogy of Fallot repair?

2019 ◽  
Vol 29 (6) ◽  
pp. 960-966
Author(s):  
Xin Tao Ye ◽  
Edward Buratto ◽  
Igor E Konstantinov ◽  
Yves d’Udekem
Keyword(s):  
Tetralogy Of Fallot ◽  
Valve Replacement ◽  
Exercise Capacity ◽  
Ventricular Arrhythmias ◽  
Observational Studies ◽  
Pulmonary Valve ◽  
Pulmonary Valve Replacement ◽  
Outflow Tract ◽  
Rv Function ◽  
Tetralogy Of Fallot Repair

AbstractA best evidence topic in cardiac surgery was written according to a structured protocol. The question addressed was whether the transatrial-transpulmonary approach to tetralogy of Fallot repair in non-neonatal patients provides superior outcomes compared with the transventricular approach. Altogether, 175 papers were found using the reported search, of which 11 represented the best evidence to answer the clinical question. Two randomized controlled trials (RCTs) and 3 observational studies showed that the transatrial approach resulted in better preservation of right ventricular (RV) function, whereas 4 observational studies showed no significant difference. Three observational studies showed better attenuation of RV dilatation, whereas 3 showed no difference. One RCT and 2 observational studies showed lower incidence of postoperative ventricular arrhythmias, while 1 RCT and 4 observational studies showed no difference. Two observational studies demonstrated greater freedom from reoperation, 1 RCT and 2 observational studies showed no difference, while 1 retrospective study observed a higher incidence of residual RV outflow tract obstruction and lower freedom from reoperation in infants. Two observational studies reported lower risk of requiring pulmonary valve replacement, whereas 2 reported no difference. Three observational studies reported superior exercise capacity, while 1 reported no difference. No difference in long-term survival was demonstrated. The results presented suggest that transatrial repair of tetralogy of Fallot confers superior or equivalent outcomes in terms of preservation of RV function and volume, ventricular arrhythmias, need for pulmonary valve replacement, and exercise capacity compared with transventricular repair. However, the incidence of residual RV outflow tract obstruction may be higher in infants undergoing transatrial repair.

The left heart after pulmonary valve replacement in adults late after tetralogy of Fallot repair

2012 ◽  
Vol 160 (3) ◽  
pp. 165-170 ◽  
Author(s):  
Daniel Tobler ◽  
Andrew M. Crean ◽  
Andrew N. Redington ◽  
Glen S. Van Arsdell ◽  
Christopher A. Caldarone ◽  
...  
Keyword(s):  
Tetralogy Of Fallot ◽  
Valve Replacement ◽  
Pulmonary Valve ◽  
Pulmonary Valve Replacement ◽  
Left Heart ◽  
Tetralogy Of Fallot Repair

Timing of pulmonary valve replacement after tetralogy of Fallot repair

2012 ◽  
Vol 10 (7) ◽  
pp. 917-923 ◽  
Author(s):  
Luciane Piazza ◽  
Massimo Chessa ◽  
Alessandro Giamberti ◽  
Claudio Maria Bussadori ◽  
Gianfranco Butera ◽  
...  
Keyword(s):  
Tetralogy Of Fallot ◽  
Valve Replacement ◽  
Pulmonary Valve ◽  
Pulmonary Valve Replacement ◽  
Tetralogy Of Fallot Repair

Exercise capacity, quality of life, and resilience after repair of tetralogy of Fallot: a cross-sectional study of patients operated between 1964 and 2009

2013 ◽  
Vol 24 (1) ◽  
pp. 79-86 ◽  
Author(s):  
Alessandra Frigiola ◽  
Catherine Bull ◽  
Jo Wray
Keyword(s):  
Quality Of Life ◽  
Tetralogy Of Fallot ◽  
Valve Replacement ◽  
Pulmonary Valve ◽  
Pulmonary Valve Replacement ◽  
Health Related Quality ◽  
Related Quality ◽  
Health Related ◽  
Tetralogy Of Fallot Repair

AbstractIntroductionPatients with repaired tetralogy of Fallot have good long-term survival but less is known about the subjectively assessed quality of life or objectively measured functional status of those who have not required subsequent pulmonary valve replacement. We assessed these parameters in a group of children and adults free from pulmonary valve replacement after tetralogy of Fallot repair.Methods and resultsA random sample of 50 subjects – 16 children and 34 adults, aged 4.1–56.7 years – who had undergone tetralogy of Fallot repair and were free from subsequent pulmonary valve replacement underwent cardiopulmonary exercise testing and completed standardised questionnaires assessing health-related quality of life and resilience. Patients were generally asymptomatic (median New York Heart Association class = I). Exercise capacity was within two standard deviations of normal for most children and adults (mean z VO2max: 0.20 ± 1.5; mean z VE/VCO2: −0.9 ± 1.3). Children reported a total health-related quality of life score similar to healthy norms (78 ± 10 versus 84 ± 1, p = 0.73). Adult survivors also reported quality of life scores comparable to healthy norms. Resilience was highly correlated with all domains of health-related quality of life (r = 0.713, p < 0.0001).ConclusionsPatients who have undergone tetralogy of Fallot repair in childhood and have not required pulmonary valve replacement have a good long-term health-related quality of life. The finding that patients with greater resilience had better health-related quality of life suggests that it may be beneficial to implement interventions to foster resilience.

Right ventricular functional recovery depends on timing of pulmonary valve replacement in tetralogy of Fallot: a video kinematic study

2021 ◽  
Author(s):  
Giacomo Rozzi ◽  
Francesco Paolo Lo Muzio ◽  
Lorenzo Fassina ◽  
Stefano Rossi ◽  
Rosario Statello ◽  
...  
Keyword(s):  
Magnetic Resonance ◽  
Tetralogy Of Fallot ◽  
Valve Replacement ◽  
Functional Recovery ◽  
Pulmonary Valve ◽  
Pulmonary Valve Replacement ◽  
Volume Index ◽  
End Diastolic Volume ◽  
Kinematic Evaluation ◽  
Tetralogy Of Fallot Repair

Abstract OBJECTIVES Indications for and timing of pulmonary valve replacement (PVR) after tetralogy of Fallot repair are controversial. Among magnetic resonance imaging indices proposed to time valve replacement, a right ventricular (RV) end-diastolic volume index greater than 160 ml/m2 is often used. Recent evidence suggests that this value may still identify patients with irreversible RV dysfunction, thus hindering recovery. Our goal was to define, using intraoperative video kinematic evaluation, whether a relationship exists between timing of PVR and early functional recovery after surgery. METHODS Between November 2016 and November 2018, a total of 12 consecutive patients aged 27.1 ± 19.1 years underwent PVR on average 22.2 ± 13.3 years after tetralogy of Fallot repair. Mean RV end-diastolic volume evident on the magnetic resonance images was 136.9 ± 35.7 ml/m2. Intraoperative cardiac kinematics were assessed by video kinematic evaluation via a high-speed camera acquiring videos at 200 fps before and after valve replacement. RESULTS Patients presenting with RV end-diastolic volume &lt;147 ml/m2 were significantly younger (11.2 ± 5.0 vs 38.4 ± 17.0; P = 0.005) and had a shorter time interval to valve replacement (11.0 ± 5.2 vs 30.1 ± 11.3; P = 0.03). The entire population showed a moderate correlation among energy expenditure, cardiac fatigue, perimeter of contraction and preoperative RV end-diastolic volume index. Both groups showed a reduction in all kinematic parameters after PVR, but those with end-diastolic volume &gt;147 ml/m2 showed an unpredictable outcome. CONCLUSIONS Video kinematic evaluation provides insight into intraoperative RV recovery in patients with tetralogy of Fallot undergoing PVR. Accordingly, functional recovery can be expected in patients with preoperative end-diastolic volume &lt;147 ml/m2.

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