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Bojórquez Martínez CA, García Murillo IM, Segón Mora S, López Mereles A. Tetralogy of Fallot: Hypoxia, the villain of the story? Birth Defects Res 2024; 116:e2279. [PMID: 38277413 DOI: 10.1002/bdr2.2279] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Revised: 11/16/2023] [Accepted: 11/17/2023] [Indexed: 01/28/2024]
Abstract
BACKGROUND Tetralogy of Fallot (ToF) is a cyanotic congenital heart disease, composed of four malformations: persistent communication between the right and the left ventricle, pulmonary stenosis, overriding aorta, and right ventricle hypertrophy. The etiology of this disease is not entirely known as yet, but it has been proposed that the pathology has genetic components. During embryonic development, the fetus is exposed to a physiological hypoxia to facilitate the formation of blood vessels and blood cells through de novo processes. METHODS After researching scientific databases on the implications of oxygen on the normal and abnormal development of organs, especially the heart, we were able to propose that oxygen deprivation may be the cause of the disease. RESULTS During this period, the hypoxia-inducible factor is activated and triggers transcriptional responses that enable adaptation to the hypoxic environment through angiogenic activation. High levels of this protein can alter certain physiological pathways, such as those related to the vascular endothelial growth factor. Research has shown that prolonged oxygen deprivation during embryological development can lead to the occurrence of congenital heart diseases, such as ToF. CONCLUSIONS Studies using animal models have demonstrated that the deficiency or disruption of a protein called "CITED2," which plays an important role in cardiac morphogenesis and its loss, results in the alteration of pluripotent, cardiac, and neural lineage differentiation, thereby disrupting the normal development of the heart and other tissues.
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Affiliation(s)
| | | | - Santiago Segón Mora
- Faculty of Medicine, Facultad Mexicana de Medicina-La Salle University, Mexico City, Tlalpan, Mexico
| | - Andrea López Mereles
- Faculty of Medicine, Facultad Mexicana de Medicina-La Salle University, Mexico City, Tlalpan, Mexico
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Liu Q, Wu X, Li Y, Wang H, An R, Dou D, Bie D, Jia Y, Yuan S, Yan F, Ding J. Effect of hemoglobin and oxygen saturation on adverse outcomes in children with tetralogy of fallot: a retrospective observational study. BMC Anesthesiol 2023; 23:346. [PMID: 37848817 PMCID: PMC10580598 DOI: 10.1186/s12871-023-02290-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Accepted: 09/21/2023] [Indexed: 10/19/2023] Open
Abstract
BACKGROUND Tetralogy of Fallot (TOF) is a common cyanotic congenital heart malformation that carries a high risk of right-to-left shunting. Anemia is characterized by decreased hemoglobin (Hb) levels that can affect tissue oxygen delivery and impact postoperative recovery in patients. Chronic hypoxia caused by right-to-left shunting of TOF could lead to compensatory increases in Hb to maintain systemic oxygen balance. This study aims to investigate whether preoperative Hb and blood oxygen saturation (SpO2) can predict adverse outcomes in children undergoing corrective surgery for TOF. METHODS This retrospective study included patients under 18 years of age who underwent corrective surgery for TOF at Fuwai Hospital between January 2016 and December 2018. Adverse outcomes, including in-hospital death, extracorporeal membrane oxygenation implantation, ICU stay > 30 days, and severe complications, were considered as the primary outcome. Univariable and multivariable logistic analyses were performed to identify independent risk factors for adverse outcomes. Propensity score-matched (PSM) analysis was also conducted to minimize the confounding factors. RESULTS A total of 596 children were included in the study, of which 64 (10.7%) experienced adverse outcomes. Hb*SpO2 < aaHb was identified as an independent risk factor for adverse outcomes (OR = 2.241, 95% CI = 1.276-3.934, P = 0.005) after univariable and multivariable logistic analyses. PSM analysis further confirmed the association between Hb*SpO2 < aaHb and adverse outcomes. Patients with Hb*SpO2 < aaHb had a significantly higher incidence of postoperative adverse outcomes, longer time of mechanical ventilation, and hospital stay, as well as higher in-hospital costs. CONCLUSIONS Hb*SpO2 < aaHb is significantly associated with adverse outcomes in children undergoing corrective surgery for TOF. Clinicians can use this parameter to early identify high-risk children and optimize their postoperative management.
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Affiliation(s)
- Qiao Liu
- Department of Anesthesiology, Fuwai Hospital, National Center of Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, 167 Beilishi Road, Xicheng District, Beijing, 100037 China
| | - Xie Wu
- Department of Anesthesiology, Fuwai Hospital, National Center of Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, 167 Beilishi Road, Xicheng District, Beijing, 100037 China
| | - Yinan Li
- Department of Anesthesiology, Fuwai Hospital, National Center of Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, 167 Beilishi Road, Xicheng District, Beijing, 100037 China
| | - Hongbai Wang
- Department of Anesthesiology, Fuwai Hospital, National Center of Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, 167 Beilishi Road, Xicheng District, Beijing, 100037 China
| | - Ran An
- Department of Anesthesiology, Fuwai Hospital, National Center of Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, 167 Beilishi Road, Xicheng District, Beijing, 100037 China
| | - Dou Dou
- Department of Anesthesiology, Fuwai Hospital, National Center of Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, 167 Beilishi Road, Xicheng District, Beijing, 100037 China
| | - Dongyun Bie
- Department of Anesthesiology, Fuwai Hospital, National Center of Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, 167 Beilishi Road, Xicheng District, Beijing, 100037 China
| | - Yuan Jia
- Department of Anesthesiology, Fuwai Hospital, National Center of Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, 167 Beilishi Road, Xicheng District, Beijing, 100037 China
| | - Su Yuan
- Department of Anesthesiology, Fuwai Hospital, National Center of Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, 167 Beilishi Road, Xicheng District, Beijing, 100037 China
| | - Fuxia Yan
- Department of Anesthesiology, Fuwai Hospital, National Center of Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, 167 Beilishi Road, Xicheng District, Beijing, 100037 China
| | - Jie Ding
- Department of Anesthesiology, Fuwai Hospital, National Center of Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, 167 Beilishi Road, Xicheng District, Beijing, 100037 China
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Khan MS, Jan A, Ahmed H, Khan M, Khan AD, Shakil R, Khan B, Aman Z, Ali WS, Mahmood A. Outcomes of Surgical Repair of Tetralogy of Fallot: A Comparison Between the Adult and Pediatric Population. Cureus 2023; 15:e41467. [PMID: 37546072 PMCID: PMC10404136 DOI: 10.7759/cureus.41467] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/06/2023] [Indexed: 08/08/2023] Open
Abstract
Introduction Tetralogy of Fallot (TOF) is the most common cyanotic congenital heart disease. Early detection and timely treatment have provided successful repair of the anomaly in the developed world. However, in the developing world, there is still a burden of uncorrected TOF patients reaching adulthood. The goal of this study is to determine whether there is any difference in postoperative complications between adult and pediatric populations following surgical correction for TOF. Methods This study involved all those patients who received primary or secondary surgical repair for TOF in our facility between January 2017 and December 2020. The patients were split according to their age into the pediatric group if they were under 18 years and the adult group if they were 18 years or older. Patients with absent pulmonary valve or pulmonary atresia were not included in this study. Patients with large major aortopulmonary collateral arteries (MAPCA) were also excluded from this study. All patients underwent total correction through a median sternotomy approach. The ventricular septal defect was closed with a Bard knitted fiber patch. The right ventricular outflow tract (RVOT) was augmented by excising muscle bands or fibrous bands in the RVOT. If the annulus was smaller than the 3.5 z score, then a transannular patch was done using an autologous pericardium. The main pulmonary artery was augmented in every surgery using an autologous pericardial patch. All patients were shifted to the ICU on the ventilator and were extubated after fulfillment of the extubation criteria. Postoperative complications measured included re-opening, re-intubation, prolonged ventilation (>24 hours), and mortality within the index hospital admission. The clinical data of all patients were prospectively collected and analyzed using the chi-square test and t-test. A p-value of less than or equal to 0.05 was considered significant. Results The total number of patients was 134. This included 83 males (60.1%). A total of 114 patients who were aged below 18 years were included in the pediatric group, and 20 patients aged equal to or more than 18 years were included in the adult group. The mean average perfusion time in minutes in the adult group was 125.8 and in the pediatric group, it was 98.79. Similarly, the mean average of the cross-clamp time was also longer in the adult group at 89.55 minutes versus 69.63 minutes in the pediatric group. Overall, in the adult group, three (15%) patients had postoperative complications, while in the pediatric group, a total of 14 (11.9%) patients had postoperative complications (p = 0.001). However, there was no significant difference in the number of re-openings (8.5% vs. 10%; p = 0.8). The total mortality observed was 16 (11.59%). This included 14 (11.9%) in the pediatric group and two (10%) in the adult group. There was no significant difference between the two groups (p = 0.8). Conclusions Surgical repair of TOF can be performed in both adult and pediatric populations with acceptable outcomes. The mortality rate was found to be slightly greater in the pediatric population compared to the adults. However, it can be seen that the number of postoperative complications is greater in adults. Further research is needed to optimize outcomes for both pediatric and adult patients with TOF.
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Affiliation(s)
| | - Azam Jan
- Cardiothoracic Surgery, Rehman Medical Institute, Peshawar, PAK
| | - Haseeb Ahmed
- Cardiothoracic and Vascular Surgery, Rehman Medical Institute, Peshawar, PAK
| | | | - Ahmad D Khan
- Endodontics, Sardar Begum Dental College, Peshawar, PAK
| | - Rafat Shakil
- Cardiothoracic Surgery, Rehman Medical Institute, Peshawar, PAK
| | - Bahauddin Khan
- Cardiothoracic Surgery, Rehman Medical Institute, Peshawar, PAK
| | - Zarkesha Aman
- Ophthalmology, Hayatabad Medical Complex, Peshawar, PAK
| | - Waleed S Ali
- Cardiothoracic Surgery, Rehman Medical Institute, Peshawar, PAK
| | - Ahmad Mahmood
- Cardiothoracic Surgery, Rehman Medical Institute, Peshawar, PAK
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Mukhopadhyay M, Ghoshal PK, Ganguly D, Chatterjee N. Tetralogy of Fallot Presenting with Superior Vena Cava Syndrome - A Rare Presentation. Heart Views 2023; 24:54-58. [PMID: 37124433 PMCID: PMC10144409 DOI: 10.4103/heartviews.heartviews_62_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Accepted: 01/22/2023] [Indexed: 02/24/2023] Open
Abstract
Tetralogy of Fallot (TOF) presenting with superior vena cava (SVC) syndrome is an exceedingly rare scenario. The diagnosis of this condition is still a difficult task due to its unspecific clinical features and unclear recommendations for the best diagnostic tools. We report an interesting case of a 23-year-old male who was found to have TOF with the presentation of SVC syndrome after a sequential diagnosis. The timely diagnosis helped in the successful management of the patient. Through this case, we want to make clinicians aware of such a rare association and its diagnosis.
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Affiliation(s)
| | - Pradip Kumar Ghoshal
- Department of Cardiology, Institute of Post Graduate Medical Education and Research, Kolkata, West Bengal, India
| | - Debpratim Ganguly
- Department of Medicine, Midnapore Medical College and Hospital, Midnapore, West Bengal, India
| | - Nandini Chatterjee
- Department of Medicine, Institute of Post Graduate Medical Education and Research, Kolkata, India
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Routine Perioperative Esmolol After Infant Tetralogy of Fallot Repair: Single-Center Retrospective Study of Hemodynamics. Pediatr Crit Care Med 2022; 23:e583-e589. [PMID: 36200768 DOI: 10.1097/pcc.0000000000003088] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
OBJECTIVES Currently, surgical repair of tetralogy of Fallot (TOF) is associated with an 1.1% 30-day mortality rate. Those with junctional ectopic tachycardia (JET) and restrictive right ventricular physiology have poorer outcomes. Routine postoperative adrenergic or inodilator therapy has been reported, while beta-blockade following cardiopulmonary bypass has not. This study evaluated routine perioperative treatment with esmolol in infants undergoing TOF repair. DESIGN Retrospective chart review of the perioperative course following TOF repair. SETTING Single-center case series describing perioperative management of TOF in a cardiac ICU. PATIENTS This study reviewed all patients less than 18 months old who underwent TOF repair, excluding cases of TOF with absent pulmonary valve or atrioventricular septal defect, at our institution from June 2018 to April 2021. INTERVENTIONS This review investigates the hemodynamic effects of esmolol following cardiopulmonary bypass for TOF repair. MEASUREMENTS AND MAIN RESULTS Preoperative clinical characteristics and perioperative course were extracted from the medical record. Descriptive statistics were used. Twenty-six patients receiving perioperative esmolol after TOF repair were identified and included. Postoperative hemodynamic parameters were within a narrow range with minimal vasoactive support in most patients. Three of 26 patients experienced JET, and one of 26 of whom had a brief cardiac arrest. Median and interquartile range (IQR) for hospital and postoperative length of stay was 7 days (IQR, 6-9 d) and 6 days (IQR, 5-8 d), respectively. There were no 30-day or 1-year mortalities. CONCLUSIONS In this infant cohort, our experience is that the routine use of postoperative esmolol is associated with good cardiac output with minimal requirement for vasoactive support in most patients. We believe optimal postoperative management of infant TOF repair requires a meticulous multidisciplinary approach, which in our experience is enhanced with routine postoperative esmolol treatment.
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Azimi G, Bozorgmehr R, Sattari P, Azimi A, Azimi H, Marzban-Rad S. Physiologic function of mediastinum space. Ann Med Surg (Lond) 2022; 82:104670. [PMID: 36268434 PMCID: PMC9577664 DOI: 10.1016/j.amsu.2022.104670] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Revised: 09/09/2022] [Accepted: 09/10/2022] [Indexed: 11/20/2022] Open
Abstract
The mediastinum forms the central part of the thoracic cavity that is surrounded by pleural space on the two sides, thoracic vertebrae at the posterior, thoracic inlet on the top, and diaphragm at the bottom. It encompasses cardiopulmonary organs and organ systems. Pathological dysfunction or deformity in any part of the mediastinum can have adverse cardiovascular and respqiratory effects. Pectus excavatum and pectus carinatum are the most common congenital chest deformities that are characterized by sternal depression and protuberance of the sternum, respectively. Together, these account for 90% of chest wall deformities. Patients are known to be represented with respiratory distress and cardiovascular dysfunction. The aim of the review article is to present the anatomical and physiological role of the mediastinum in association with important parts of the thoracic cavity and pathological dysfunction of the mediastinum (cardiopulmonary system) due to pectus excavatum and pectus carinatum. Mediastinum forms the central part of thoracic cavity that is surrounded by pleural space. PC and PE are structural chest deformities. Chest deformation by pressing on the chin causes coughing, stridor, dyspnea and exacerbation. Clinical symptoms along with inflammation that requires urgent medical treatment.
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Affiliation(s)
- Ghasem Azimi
- Department of Internal Medicine, School of Medicine, Shahed University, Tehran, Iran
| | - Rama Bozorgmehr
- School of Medicine, Chronic Respiratory Diseases Research Center, National Research Institute of Tuberculosis and Lung Diseases, Shahid Modarres Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- Corresponding author. Pulmonary Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Parastesh Sattari
- General Practitioner, Institute of Health Education and Research, Chamran Hospital, Tehran, Iran
| | - Ali Azimi
- Student of Research Committee, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran
| | - Hossein Azimi
- Student of Research Committee, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran
| | - Saeid Marzban-Rad
- Department of Surgery, Imam-Reza Hospital, Aja University of Tehran Medical Sciences, Tehran, Iran
- Corresponding author. Aja University of Tehran Medical Sciences, Tehran, Iran.
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Identification of a De Novo LRP1 mutation in a Saudi Family with Tetralogy of Fallot. Gene X 2022; 851:146909. [PMID: 36162527 DOI: 10.1016/j.gene.2022.146909] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Revised: 07/19/2022] [Accepted: 09/19/2022] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Tetralogy of Fallot (TOF) is a rare, complex congenital heart defect caused by genetic and environmental interactions that results in abnormal heart development during the early stages of pregnancy. Genetic basis of TOF in Saudi populations is not yet studied. Therefore, the objective of this study is to screen for the molecular defects causing TOF in Saudi patients. METHODS A family with non-syndromic TOF was recruited from the Western region of Saudi Arabia. Whole exome sequencing (WES) was performed on the proband and her parents. The identified candidate variant was verified by sanger sequencing. Also, different computational biology tools were used to figure out how candidate variants affect the structure and function of candidate protein involved in TOF. RESULTS A novel heterozygous de novo mutation in LRP1 (p. G3311D) gene was identified in the index case. Also, this variant was absent in the in-house exome sequencing data of 80 healthy Saudi individuals. This variant was predicted to be likely pathogenic, as it negatively affects the biophysical chemical properties and stability of the protein. Furthermore, functional biology data from knock out mouse models confirms that molecular defects in LRP1 gene leads to cardiac defects and lethality. This variant was not previously reported in both Arab and global population genetic databases. CONCLUSION The findings in this study postulate that the LRP1 variant has a role in TOF pathogenesis and facilitate accurate diagnosis as well as the understanding of underlying molecular mechanisms and pathophysiology of the disease.
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Kakucs Z, Heidenhoffer E, Pop M. Detection of Coronary Artery and Aortic Arch Anomalies in Patients with Tetralogy of Fallot Using CT Angiography. J Clin Med 2022; 11:jcm11195500. [PMID: 36233367 PMCID: PMC9570993 DOI: 10.3390/jcm11195500] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Revised: 09/17/2022] [Accepted: 09/17/2022] [Indexed: 12/03/2022] Open
Abstract
Background: Tetralogy of Fallot (TOF) is the most common form of cyanotic congenital heart disease (CHD). Furthermore, the prevalence of anomalous origin of a coronary artery is higher in patients with TOF than in the general population (6% vs. ≤1%). Preoperative assessment of cardiovascular anatomy using computed tomography (CT) angiography enables the adaptation of the surgical approach to avoid potentially overlooked anomalies. Our purpose was to determine the prevalence of coronary artery and aortic arch anomalies in a cohort of TOF patients. Methods: In this retrospective analysis, data were collected from CT reports (2015–2021) of 105 TOF patients. All images were acquired using a 64-slice multi-detector CT (MDCT) scanner. Results: The median age of the patients was 38.7 months, with a male-to-female ratio of 1.39. The overall prevalence of coronary artery anomalies (CAAs) was 7.61% (8 of 105 cases). The anomalous origin and course of coronary arteries across the right ventricular outflow tract (RVOT; prepulmonic course) were defined in 5.71% of cases (six patients). In four of these, the left anterior descending artery (LAD) originated from the right coronary artery (RCA), while in two cases, the RCA arose from the LAD. In the remaining two patients, the coronary arteries followed an interarterial course. The most frequent anomalous aortic arch pattern in the overall TOF population was the right aortic arch (RAA) with mirror image branching, seen in 20% of patients (21 cases). The most frequent anomaly of the supra-aortic trunks was bovine configuration, found in 17.14% (18 cases). Conclusions: The prevalence of CAAs and aortic arch anomalies detected by CT angiography was in line with the data reported in anatomical specimens. Therefore, this technique represents a powerful tool for the evaluation of congenital cardiovascular anomalies.
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Affiliation(s)
- Zsófia Kakucs
- Mures County Clinical Emergency Hospital, 540136 Targu Mures, Romania
- Correspondence: (Z.K.); (E.H.)
| | - Erhard Heidenhoffer
- Clinical County Hospital Mures, 540103 Targu Mures, Romania
- Correspondence: (Z.K.); (E.H.)
| | - Marian Pop
- ME1 Department, “George Emil Palade” University of Medicine, Pharmacy, Science and Technology of Targu Mures, 540142 Targu Mures, Romania
- Emergency Institute for Cardiovascular Disease and Transplant of Targu Mures, 540136 Targu Mures, Romania
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Guerrero AF, Pineda-Rodríguez IG, Palacio AM, Obando CE, Chalela T, Camacho J, Villa C, Umaña JP, Sandoval-Reyes NF. Repair with a pulmonary neovalve in tetralogy of Fallot: does this avoid ventricular dysfunction? Interact Cardiovasc Thorac Surg 2022; 35:6595031. [PMID: 35640540 PMCID: PMC9297514 DOI: 10.1093/icvts/ivac155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Revised: 05/23/2022] [Accepted: 05/24/2022] [Indexed: 11/28/2022] Open
Affiliation(s)
- Albert Franz Guerrero
- Department of Cardiovascular Surgery, Fundación Cardioinfantil—IC, Rosario University , Bogotá, Colombia
| | | | - Andres Mauricio Palacio
- Department of Cardiovascular Surgery, Fundación Cardioinfantil—IC, Rosario University , Bogotá, Colombia
| | - Carlos Eduardo Obando
- Department of Cardiovascular Surgery, Fundación Cardioinfantil—IC, Rosario University , Bogotá, Colombia
| | - Tomas Chalela
- Department of Cardiovascular Surgery, Fundación Cardioinfantil—IC, Rosario University , Bogotá, Colombia
| | - Jaime Camacho
- Department of Cardiovascular Surgery, Fundación Cardioinfantil—IC, Rosario University , Bogotá, Colombia
| | - Carlos Villa
- Department of Cardiovascular Surgery, Fundación Cardioinfantil—IC, Rosario University , Bogotá, Colombia
| | - Juan Pablo Umaña
- Department of Cardiovascular Surgery, Fundación Cardioinfantil—IC, Rosario University , Bogotá, Colombia
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‘Health-related quality of life in operated adult patients with Tetralogy of Fallot and correlation with advanced imaging indexes and cardiopulmonary exercise test'a narrative review. Curr Probl Cardiol 2022:101184. [DOI: 10.1016/j.cpcardiol.2022.101184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Accepted: 03/22/2022] [Indexed: 11/21/2022]
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11
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Veen I, Szatmári V, Vries A, Grauw J. Anaesthetic management of a dog with tetralogy of Fallot undergoing placement of a modified Blalock‐Taussig shunt. VETERINARY RECORD CASE REPORTS 2021. [DOI: 10.1002/vrc2.256] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Iris Veen
- Department of Clinical Sciences Faculty of Veterinary Medicine Utrecht University Utrecht The Netherlands
| | - Viktor Szatmári
- Department of Clinical Sciences Faculty of Veterinary Medicine Utrecht University Utrecht The Netherlands
| | | | - Janny Grauw
- Department of Clinical Sciences Faculty of Veterinary Medicine Utrecht University Utrecht The Netherlands
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Yavasoglu NG, Can U. The effects of corrective surgical treatment on cerebral hemodynamics in pediatric patients with congenital heart disease. PROGRESS IN PEDIATRIC CARDIOLOGY 2021. [DOI: 10.1016/j.ppedcard.2021.101435] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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13
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Chávez-Saldívar S, Mego JC, Tauma-Arrué A, Coronado J, Luis-Ybáñez O, Bravo-Jaimes K. [The adult with tetralogy of fallot: what the clinical cardiologist needs to know]. ARCHIVOS PERUANOS DE CARDIOLOGIA Y CIRUGIA CARDIOVASCULAR 2021; 2:121-129. [PMID: 38274563 PMCID: PMC10809779 DOI: 10.47487/apcyccv.v2i2.138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Accepted: 06/26/2021] [Indexed: 01/27/2024]
Abstract
Tetralogy of Fallot (TOF) is the most common cyanotic congenital heart disease. After more than seven decades of the first palliative surgery, TOF prognosis has changed dramatically. The prevalence of TOF is approximately 3 per 10 000 births, representing 7 to 10% of congenital heart disease. With a higher survival into adulthood, the clinical cardiologist faces challenges in the management of this population, from severe pulmonary regurgitation to heart failure and ventricular arrhythmias. Its prevalence is approximately 3 per 10 000 live births, representing 7 to 10% of congenital heart disease. This review will describe the most relevant aspects of the care of adult patients with this disease.
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Affiliation(s)
- Samantha Chávez-Saldívar
- Facultad de Medicina San Fernando. Universidad Nacional Mayor de San Marcos. Lima, Perú.Universidad Nacional Mayor de San MarcosFacultad de Medicina San FernandoUniversidad Nacional Mayor de San MarcosLimaPeru
- Sociedad Científica de San Fernando. Lima, Perú.Sociedad Científica de San FernandoLimaPerú
| | - Juan Carlos Mego
- Facultad de Medicina San Fernando. Universidad Nacional Mayor de San Marcos. Lima, Perú.Universidad Nacional Mayor de San MarcosFacultad de Medicina San FernandoUniversidad Nacional Mayor de San MarcosLimaPeru
- Sociedad Científica de San Fernando. Lima, Perú.Sociedad Científica de San FernandoLimaPerú
| | - Astrid Tauma-Arrué
- Facultad de Medicina San Fernando. Universidad Nacional Mayor de San Marcos. Lima, Perú.Universidad Nacional Mayor de San MarcosFacultad de Medicina San FernandoUniversidad Nacional Mayor de San MarcosLimaPeru
- Sociedad Científica de San Fernando. Lima, Perú.Sociedad Científica de San FernandoLimaPerú
| | - Joel Coronado
- Facultad de Medicina San Fernando. Universidad Nacional Mayor de San Marcos. Lima, Perú.Universidad Nacional Mayor de San MarcosFacultad de Medicina San FernandoUniversidad Nacional Mayor de San MarcosLimaPeru
- Sociedad Científica de San Fernando. Lima, Perú.Sociedad Científica de San FernandoLimaPerú
| | - Odalis Luis-Ybáñez
- Facultad de Medicina San Fernando. Universidad Nacional Mayor de San Marcos. Lima, Perú.Universidad Nacional Mayor de San MarcosFacultad de Medicina San FernandoUniversidad Nacional Mayor de San MarcosLimaPeru
- Sociedad Científica de San Fernando. Lima, Perú.Sociedad Científica de San FernandoLimaPerú
| | - Katia Bravo-Jaimes
- Ahmanson/UCLA Adult Congenital Heart Disease Center. University of California. Los Angeles, Estados Unidos.University of CaliforniaAhmanson/UCLA Adult Congenital Heart Disease CenterUniversity of CaliforniaLos AngelesUSA
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Munaf M, Farooqui S, Kazmi SK, Ul-Haque I. Congenitally Corrected Transposition of Great Arteries with Dextrocardia, Patent Ductus Arteriosus, Atrial Septal Defects and Ventricular Septal Defects in a 15-Year-Old Marfanoid Habitus Patient: A Case Study. Cureus 2020; 12:e8937. [PMID: 32765983 PMCID: PMC7398687 DOI: 10.7759/cureus.8937] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
Congenitally corrected transposition of the great arteries (CCTGA) is a rare congenital cardiac anomaly defined by atrio-ventricular and ventriculo-arterial discordance. This malformation makes up less than 1% of congenital heart defects. We report here a case of a 15-year-old female who presented to our hospital with dyspnea as seen in the New York Heart Association (NYHA) Functional Classification class III and hemoptysis. She was clinically found to have marfanoid habitus, and subsequent echocardiographic study disclosed CCTGA-associated with Ebstein's anomaly, ventricular septal defect, left ventricular outflow obstruction, right ventricular outflow obstruction, co-existing dextrocardia, atrial septal defect, patent ductus arteriosus, non-confluent pulmonary arteries, and pulmonary atresia. This case highlights the association between such rare cardiac conditions. To the best of our knowledge, this is the first case of CCTGA at a young age, with the aforementioned abnormalities documented in the literature reported from Pakistan.
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Ishiyama D, Makino E, Nakamura Y, Uchida M, Onodera Y, Chambers JK, Uchida K, Matsuda F. Clinical and postmortem findings of pentalogy of Fallot in an 18-month-old Holstein heifer. J Vet Med Sci 2019; 81:1676-1679. [PMID: 31582644 PMCID: PMC6895641 DOI: 10.1292/jvms.19-0147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
An 18-month-old female Holstein Friesian heifer presented with a history of stunted growth and a recent onset of anorexia; she presented with cyanosis and eventually died. A postmortem examination revealed obstruction of the right ventricular outflow tract, ventricular septal defect, overriding aortic root, right ventricular hypertrophy, and an atrial septal defect, indicating a pentalogy of Fallot (POF). In addition to POF, the heifer also had pulmonary artery dilatation, although she did not present with patent ductus arteriosus. This heifer had the longest lifespan among the Holstein cattle reported to have POF, which may be secondary to delayed pulmonary obstruction due to deformation of one of the pulmonary valves.
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Affiliation(s)
- Dai Ishiyama
- Sekiyado Branch Office, Western Veterinary Clinical Center, Chiba Prefectural Federated Agricultural Mutual Aid Association, 462-11 Kirigasaku, Noda-shi, Chiba 270-0213, Japan
| | - Eiji Makino
- Sekiyado Branch Office, Western Veterinary Clinical Center, Chiba Prefectural Federated Agricultural Mutual Aid Association, 462-11 Kirigasaku, Noda-shi, Chiba 270-0213, Japan
| | - Yoshihiro Nakamura
- Sekiyado Branch Office, Western Veterinary Clinical Center, Chiba Prefectural Federated Agricultural Mutual Aid Association, 462-11 Kirigasaku, Noda-shi, Chiba 270-0213, Japan
| | - Makoto Uchida
- Sekiyado Branch Office, Western Veterinary Clinical Center, Chiba Prefectural Federated Agricultural Mutual Aid Association, 462-11 Kirigasaku, Noda-shi, Chiba 270-0213, Japan
| | - Yukio Onodera
- Sekiyado Branch Office, Western Veterinary Clinical Center, Chiba Prefectural Federated Agricultural Mutual Aid Association, 462-11 Kirigasaku, Noda-shi, Chiba 270-0213, Japan
| | - James K Chambers
- Department of Veterinary Medical Sciences, Graduate School of Agriculture and Life Sciences, The University of Tokyo, 1-1-1 Yayoi, Bunkyo-ku, Tokyo 113-8657, Japan
| | - Kazuyuki Uchida
- Department of Veterinary Medical Sciences, Graduate School of Agriculture and Life Sciences, The University of Tokyo, 1-1-1 Yayoi, Bunkyo-ku, Tokyo 113-8657, Japan
| | - Fuko Matsuda
- Department of Veterinary Medical Sciences, Graduate School of Agriculture and Life Sciences, The University of Tokyo, 1-1-1 Yayoi, Bunkyo-ku, Tokyo 113-8657, Japan
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