Pediatr Cardiol
Department of Pediatrics, Lucile Packard Children's Hospital, Stanford University, Stanford, CA, USA.
Published: April 2024
This study describes right ventricle (RV) characteristics and right ventricle to pulmonary artery (RV-PA) conduit function pre- and post-repair in patients with tetraology of Fallot with major aortopulmonary collaterals (TOF/MAPCAs). We reviewed patients who underwent single-stage, complete unifocalization, and repair of TOF/MAPCAs between 2006 and 2019 with available pre- and early postoperative echocardiograms. For a subset of patients, 6-12 month follow-up echocardiogram was available. RV and left ventricle (LV) characteristics and RV-PA conduit function were reviewed. Wilcoxon signed rank test and McNemar's test were used. 170 patients were reviewed, 46 had follow-up echocardiograms. Tricuspid valve annular plane systolic excursion (TAPSE) Z-scores were reduced from pre- (Z-score 0.01) to post-repair (Z-score -4.5, p < 0.001), improved but remained abnormal at follow-up (Z-score -4.0, p < 0.001). RV fractional area change (FAC) and LV ejection fraction were not significantly different before and after surgery. Conduit regurgitation was moderate or greater in 11% at discharge, increased to 65% at follow-up. RV-PA conduit failure (severe pulmonary stenosis or severe pulmonary regurgitation) was noted in 61, and 63% had dilated RV (diastolic RV area Z-score > 2) at follow-up. RV dilation correlated with the severe conduit regurgitation (p = 0.018). Longitudinal RV function was reduced after complete repair of TOF/MAPCAs, with decreased TAPSE and preserved FAC and LV ejection fraction. TAPSE improved but did not normalize at follow-up. Severe RV-PA conduit dysfunction was observed prior to discharge in 11% of patients and in 61% at follow-up. RV dilation was common at follow-up, especially in the presence of severe conduit regurgitation.
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http://dx.doi.org/10.1007/s00246-024-03412-0 | DOI Listing |
J Cardiothorac Surg
December 2024
University Teaching Hospital of Kigali, Kigali, Rwanda.
Background: While the number of cardiac surgery programs in sub-Saharan Africa are increasing, it is still insufficient. With only 0.08 pediatric cardiac surgeons per million people, few cardiac centers routinely perform pediatric cardiac surgery.
View Article and Find Full Text PDFMed J Armed Forces India
December 2024
National Manager-Health System Strengthening, United Nations Development Program (UNDP), 55 Lodhi Estate, New Delhi, India.
Background: The purpose of this paper is to compare the efficacy of dual-phase multidetector computed tomography angiography (CTA) with transthoracic echocardiogram (TTE) and cardiac catheterization angiography (CCA) in evaluation of pulmonary arteries and collateral vessels, major aortopulmonary collateral arteries (MAPCAs) in children with cyanotic congenital heart diseases.
Methods: The study was a prospective observational study where 32 pediatric patients (18 males, 14 females and age range 2-116 months) with cyanotic congenital heart diseases (CCHD) were included. All patients underwent TTE, CTA, and CCA.
Circ Cardiovasc Interv
December 2024
Department of Pediatrics, Pediatric Cardiology, Stanford University, Palo Alto, CA. (J.K.Y., L.W., A.C.T., H.C., A.W.R., L.F.P., S.R.C., A.M.D., D.B.M.).
Background: Varying rates of nonsustained ventricular tachycardia (NSVT) have been reported early after transcatheter pulmonary valve replacement (TPVR) with the Harmony valve, but data regarding rhythm outcomes beyond hospital discharge are limited. This study aims to characterize ventricular arrhythmias after Harmony TPVR from implant through mid-term follow-up.
Methods: Ventricular arrhythmia data from postimplant telemetry and follow-up extended rhythm monitoring (ERM) were analyzed after Harmony TPVR.
Heart Lung Circ
December 2024
Department of Cardiovascular Surgery, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangdong Provincial Key Laboratory of South China Structural Heart Disease, Guangzhou, China. Electronic address:
Aim: Tetralogy of Fallot (TOF) is the most common cyanotic heart disease. This study aimed to demonstrate the effects of preoperative oxygen saturation on the early prognosis of TOF and identify risk factors associated with early complications.
Method: A cohort of 1,138 patients who were diagnosed and underwent one-stage surgical repair in this hospital were retrospectively included in this study.
Pediatr Cardiol
December 2024
Division of Pediatric Cardiology, Department of Pediatrics, Stanford University School of Medicine, 750 Welch Road, Suite 305, Palo Alto, CA, 94304, USA.
Quantification of right ventricular (RV) size and function after tetralogy of Fallot repair is critical for determining timing of reintervention and outcomes. Tetralogy of Fallot patients with pulmonary atresia and major aortopulmonary collateral arteries (TOF/PA/MAPCAs) are a unique group in which the RV is subjected to various loading conditions, allowing for direct comparison. Retrospective evaluation of RV echocardiographic indices in repaired pediatric TOF/PA/MAPCAs patients (2/2002 - 4/2018).
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