Repaired tetralogy of Fallot in the adult: Monitoring and management

Heart

Volumn 94, Issue 12, 2008, Pages 1663-1669

  Huehnergarth, Kier V ^a   Gurvitz, Michelle ^a   Stout, Karen K ^a   Otto, Catherine M ^a  

^a UNIVERSITY OF WASHINGTON SCHOOL OF MEDICINE   (United States)

Author keywords

[No Author keywords available]

Indexed keywords

DISEASE COURSE; EMBRYOLOGY; EXERCISE; FALLOT TETRALOGY; HEART ARRHYTHMIA; HEART VALVE REPLACEMENT; HEART VENTRICLE SEPTUM DEFECT; HUMAN; MORBIDITY; MORTALITY; NUCLEAR MAGNETIC RESONANCE IMAGING; PATHOPHYSIOLOGY; PATIENT MONITORING; PRIORITY JOURNAL; PULMONARY VALVE INSUFFICIENCY; REVIEW; SURVIVAL RATE; UNITED STATES;

ADULT; ARRHYTHMIAS, CARDIAC; ECHOCARDIOGRAPHY; EXERCISE TOLERANCE; HUMANS; PRACTICE GUIDELINES AS TOPIC; PULMONARY VALVE INSUFFICIENCY; TETRALOGY OF FALLOT;

EID: 56749165446     PISSN: 13556037     EISSN: 1468201X     Source Type: Journal    
DOI: 10.1136/hrt.2008.147249     Document Type: Review

References (21)

1. Murphy JG, Gersh BJ, Mair DD, et al. Long-term outcome in patients undergoing surgical repair of tetralogy of Fallot. N Engl J Med 1993;329:593-9.
2. Hoffman JH, Kaplan S, Liberthson RR. Prevalence of congenital heart disease. Am Heart J 2004;147:425-39.
3. Marelli AJ, Mackie AS, Ionescu-Ittu R, et al. Congenital heart disease in the general population: changing prevalence and age distribution. Circulation 2007;115:163-72. ▶ This population based study shows that from 1985 to 2000 there has been an increase in the prevalence and age of patients with severe congenital heart disease.
4. Niwa K, Siu SC, Webb GD, et al. Progressive aortic root dilatation in adults late after repair of tetralogy of Fallot. Circulation 2002;106:1374-8.
5. Kim WH, Seo JW, Kim SJ, et al. Aortic dissection late after repair of tetralogy of Fallot. Int J Cardiol 2005;101:515-16.
6. Tan JL, Gatzoulis MA, Ho SY. Aortic root disease in tetralogy of Fallot. Curr Opin Cardiol 2006;21:569-72. ▶ Review of aortic root dilation in patients with repaired ToF.
7. Davlouros PA, Kilner PJ, Hornung TS, et al. Right ventricular function in adults with repaired tetralogy of Fallot assessed with cardiovascular magnetic resonance imaging: detrimental role of right ventricular outflow aneurysms or akinesia and adverse right-to-left ventricular interaction. J Am Coll Cardiol 2002;40:2044-52. ▶ MRI study showing that pulmonary regurgitant fraction and RV aneurysm/akinesia predict RV dilation.
8. Diller GP, Dimopoulos K, Okonko D, et al. Exercise intolerance in adult congenital heart disease: comparative severity, correlates, and prognostic implication. Circulation 2005;112:828-35. ▶ Important study showing that exercise capacity is reduced in patients with congenital heart disease including ToF. Notably, exercise capacity was limited in patients who were reportedly asymptomatic. Also, exercise limitation was similar to patients with chronic heart failure.
9. Gatzoulis MA, Balaji S, Webber SA, et al. Risk factors for arrhythmia and sudden cardiac death late after repair of tetralogy of Fallot: a multicentre study. Lancet 2000;356:975-81. ▶ Large, multicentre cohort study examining surgical, electrocardiographic and late haemodynamic data as risk factors for sudden cardiac death.
10. Babu-Narayan SV, Kilner PJ, Li W, et al. Ventricular fibrosis suggested by cardiovascular magnetic resonance in adults with repaired tetralogy of Fallot and its relationship to adverse markers of clinical outcome. Circulation 2006;113:405-13. ▶ MRI study demonstrating that ventricular fibrosis detected by late gadolinium enhancement is common in patients with repaired ToF. Higher degrees of fibrosis were associated with multiple adverse markers of outcome.
11. Gatzoulis MA, Till JA, Somerville J, et al. Mechanoelectrical interaction in tetralogy of Fallot. QRS prolongation relates to right ventricular size and predicts malignant ventricular arrhythmias and sudden death. Circulation 1995;92:231-7.
12. Gerson A Jr, Nihill MR, McNamara DG, et al. Status of the adult and adolescent after repair of tetralogy of Fallot. Circulation 1979;59:1232-40.
13. Henkens IR, van Straten A, Schalij MJ, et al. Predicting outcome of pulmonary valve replacement in adult tetralogy of Fallot patients. Ann Thorac Surg 2007;83:907-11.
14. Buechel ER, Dave HH, Kellenberger CJ, et al. Remodelling of the right ventricle after early pulmonary valve replacement in children with repaired tetralogy of Fallot: assessment by cardiovascular magnetic resonance. Eur Heart J 2005;26:2721-7.
15. Oosterhof T, van Straten A, Vliegen HW, et al. Preoperative thresholds for pulmonary valve replacement in patients with corrected tetralogy of Fallot using cardiovascular magnetic resonance. Circulation 2007;116:545-51. ▶ Relatively large retrospective study (71 patients) looking at the change in RV volume after pulmonary valve replacement. No threshold existed above which RV volumes did not decrease. Thresholds for normalisation of RV volumes were determined.
16. Therrien J, Provost Y, Merchant'N, et al. Optimal timing for pulmonary valve replacement in adults after tetralogy of Fallot repair. Am J Cardiol 2005;95:779-82.
17. van Straten A, Vliegen HW, Lamb HJ, et al. Time course of diastolic and systolic function improvement after pulmonary valve replacement in adult patients with tetralogy of Fallot. J Am Coll Cardiol 2005;46:1559-64. ▶ Prospective MRI study showing improvement in RV ejection fraction (corrected for pulmonary regurgitation) after pulmonary valve replacement.
18. Warner KG, O'Brien PK, Rhodes J, et al. Expanding the indications for pulmonary valve replacement after repair of tetralogy of Fallot. Ann Thorac Surg 2003;76:1066-71; discussion 1071.
19. Therrien J, Siu SC, Harris L, et al. Impact of pulmonary valve replacement on arrhythmia propensity late after repair of tetralogy of Fallot. Circulation 2001;103:2489-94. ▶ This study addresses whether pulmonary valve replacement for pulmonary regurgitation in patients with repaired ToF reduces arrhythmias. They showed that pulmonary valve replacement results in stabilisation of QRS duration and (with intraoperative cryoablation) a decrease in the incidence of pre-existing atrial or ventricular tachyarrhythmias.
20. Khambadkone S, Coats L, Taylor A, et al. Percutaneous pulmonary valve implantation in humans: results in 59 consecutive patients. Circulation 2005;112:1189-97. ▶ Clinical results of a percutaneously delivered valved stent into the RV outflow tract.
21. Wilson W, Taubert KA, Gewitz M, et al. Prevention of infective endocarditis: guidelines from the American Heart Association: a guideline from the American Heart Association Rheumatic Fever, Endocarditis, and Kawasaki Disease Committee, Council on Cardiovascular Disease in the Young, and the Council on Clinical Cardiology, Council on Cardiovascular Surgery and Anesthesia, and the Quality of Care and Outcomes Research Interdisciplinary Working Group. Circulation 2007;116:1736-54.