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Tetralogy of Fallot

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Pediatric and Congenital Cardiology, Cardiac Surgery and Intensive Care

Abstract

Tetralogy of Fallot is one of the most common congenital cardiac malformations and consists of (1) ventricular septal defect, (2) right ventricular outflow tract obstruction, (3) aortic override, and (4) right ventricular hypertrophy. The initial presentation of the patient with Tetralogy of Fallot is variable and dependent on the degree of right ventricular outflow tract obstruction. Initial medical management of Tetralogy of Fallot is aimed at monitoring and managing hypoxemia and preventing hypercyanotic spells. A small percentage of patients will present with significant cyanosis in the neonatal period. The majority, however, will have stable pulmonary artery blood flow and require no immediate treatment. Cyanosis gradually progresses as pulmonary blood flow is limited by increasing right ventricular outflow tract obstruction. Diagnosis is usually established with transthoracic echocardiography. Further anatomic detail and some functional data may also be garnered with cardiac MRI or cardiac catheterization, which may help define and characterize additional sources of pulmonary blood flow or abnormalities of systemic venous return.

Indications for surgical intervention are symptoms of hypercyanotic episodes or the presence of oxygen saturations that are persistently below 75–80 %. In most children with Tetralogy of Fallot, elective complete repair is recommended by 1 year of age with most centers recommending elective repair in the first 3–6 months of life. While palliative procedures can be performed to delay the need for definitive complete repair, most centers favor early complete repair, reserving palliative procedures for those patients that have contraindications to open cardiac surgery. In the current era, outcomes for complete repair are excellent, even when definitive repair is required in the neonatal period.

Morphology and associated defects in tetralogy of Fallot may include tetralogy of Fallot with absent pulmonary valve, tetralogy of Fallot with complete atrioventricular septal defect, and tetralogy of Fallot with pulmonary atresia and multiple aortopulmonary collaterals. These entities may behave differently, and strategy and timing for surgical repair are often more complicated than for simple tetralogy of Fallot. Following repair of tetralogy of Fallot, lifelong follow-up is usually indicated in order to monitor for recurrent or persistent pathology of the right ventricular outflow tract and for appropriate intervention if indicated.

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References

  1. Eldadah ZA, Hamosh A, Biery NJ, Montgomery RA, Duke M, Elkins R, Dietz HC (2001) Familial tetralogy of Fallot caused by mutation in the jagged1 gene. Hum Mol Genet 10:163–169

    Article  CAS  PubMed  Google Scholar 

  2. Goldmuntz E, Geiger E, Benson DW (2001) NKX2.5 mutations in patients with tetralogy of Fallot. Circulation 104:2565–2568

    Article  CAS  PubMed  Google Scholar 

  3. Fallot ÉLA (1988) Contribution à l’anatomie pathologique de la maladie bleue (cyanose cardiaque). n.p.

    Google Scholar 

  4. Blalock A, Taussig HB (1945) The surgical treatment of malformation of the heart in which there is pulmonary stenosis or pulmonary atresia. JAMA 128:189

    Article  Google Scholar 

  5. Potts WJ, Smith S, Gibson S (1946) Anastomosis of the aorta to a pulmonary artery; certain types in congenital heart disease. J Am Med Assoc 132:627–631

    Article  CAS  PubMed  Google Scholar 

  6. Waterston DJ (1962) Treatment of Fallot’s tetralogy in children under 1 year of age. Rozhl Chir 41:181–183

    CAS  PubMed  Google Scholar 

  7. Lillehei CW, Cohen M, Warden HE, Read RC, Aust JB, Dewall RA, Varco RL (1955) Direct vision intracardiac surgical correction of the tetralogy of Fallot, pentalogy of Fallot, and pulmonary atresia defects; report of first ten cases. Ann Surg 142:418–442

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  8. Kirklin JW, Dushane JW, Patrick RT, Donald DE, Hetzel PS, Harshbarger HG, Wood EH (1955) Intracardiac surgery with the aid of a mechanical pump-oxygenator system (gibbon type): report of eight cases. Proc Staff Meet Mayo Clin 30:201–206

    CAS  PubMed  Google Scholar 

  9. Bacha EA, Scheule AM, Zurakowski D, Erickson LC, Hung J, Lang P, Mayer JE Jr, del Nido PJ, Jonas RA (2001) Long-term results after early primary repair of tetralogy of Fallot. J Thorac Cardiovasc Surg 122:154–161

    Article  CAS  PubMed  Google Scholar 

  10. Lindberg HL, Saatvedt K, Seem E, Hoel T, Birkeland S (2011) Single-center 50 years’ experience with surgical management of tetralogy of Fallot. Eur J Cardiothorac Surg 40:538–542

    PubMed  Google Scholar 

  11. Van Praagh R, Van Praagh S, Nebesar RA, Muster AJ, Sinha SN, Paul MH (1970) Tetralogy of Fallot: underdevelopment of the pulmonary infundibulum and its sequelae. Am J Cardiol 26:25–33

    Article  PubMed  Google Scholar 

  12. Suzuki A, Ho SY, Anderson RH, Deanfield JE (1990) Further morphologic studies on tetralogy of Fallot, with particular emphasis on the prevalence and structure of the membranous flap. J Thorac Cardiovasc Surg 99:528–535

    CAS  PubMed  Google Scholar 

  13. Dickinson DF, Wilkinson JL, Smith A, Hamilton DI, Anderson RH (1982) Variations in the morphology of the ventricular septal defect and disposition of the atrioventricular conduction tissues in tetralogy of Fallot. Thorac Cardiovasc Surg 30:243–249

    Article  CAS  PubMed  Google Scholar 

  14. Kurosawa H, Imai Y (1988) Surgical anatomy of the atrioventricular conduction bundle in tetralogy of Fallot. New findings relevant to the position of the sutures. J Thorac Cardiovasc Surg 95:586–591

    CAS  PubMed  Google Scholar 

  15. Anderson RH, Allwork SP, Ho SY, Lenox CC, Zuberbuhler JR (1981) Surgical anatomy of tetralogy of Fallot. J Thorac Cardiovasc Surg 81:887–896

    CAS  PubMed  Google Scholar 

  16. Vargas FJ, Kreutzer GO, Pedrini M, Capelli H, Rodriguez CA (1986) Tetralogy of Fallot with subarterial ventricular septal defect. Diagnostic and surgical considerations. J Thorac Cardiovasc Surg 92:908–912

    CAS  PubMed  Google Scholar 

  17. Altrichter PM, Olson LJ, Edwards WD, Puga FJ, Danielson GK (1989) Surgical pathology of the pulmonary valve: a study of 116 cases spanning 15 years. Mayo Clin Proc 64:1352–1360

    Article  CAS  PubMed  Google Scholar 

  18. Shimazaki Y, Blackstone EH, Kirklin JW (1984) The natural history of isolated congenital pulmonary valve incompetence: surgical implications. Thorac Cardiovasc Surg 32:257–259

    Article  CAS  PubMed  Google Scholar 

  19. Chiariello L, Meyer J, Wukasch DC, Hallman GL, Cooley DA (1975) Intracardiac repair of tetralogy of Fallot. Five-year review of 403 patients. J Thorac Cardiovasc Surg 70:529–535

    CAS  PubMed  Google Scholar 

  20. Miller RA, Lev M, Paul MH (1962) Congenital absence of the pulmonary valve. The clinical syndrome of tetralogy of Fallot with pulmonary regurgitation. Circulation 26:266–278

    Article  CAS  PubMed  Google Scholar 

  21. Bove EL, Shaher RM, Alley R, McKneally M (1972) Tetralogy of Fallot with absent pulmonary valve and aneurysm of the pulmonary artery: report of two cases presenting as obstructive lung disease. J Pediatr 81:339–343

    Article  CAS  PubMed  Google Scholar 

  22. Humes RA, Driscoll DJ, Danielson GK, Puga FJ (1987) Tetralogy of Fallot with anomalous origin of left anterior descending coronary artery. Surgical options. J Thorac Cardiovasc Surg 94:784–787

    CAS  PubMed  Google Scholar 

  23. Boon AR, Farmer MB, Roberts DF (1972) A family study of Fallot’s tetralogy. J Med Genet 9:179–192

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  24. Di Felice V, Zummo G (2009) Tetralogy of Fallot as a model to study cardiac progenitor cell migration and differentiation during heart development. Trends Cardiovasc Med 19:130–135

    Article  PubMed  Google Scholar 

  25. Kirklin JW, Barratt-Boyes BG (1993) Cardiac surgery: morphology, diagnostic criteria, natural history, techniques, results, and indications. Churchill Livingstone, New York

    Google Scholar 

  26. Groh MA, Meliones JN, Bove EL, Kirklin JW, Blackstone EH, Lupinetti FM, Snider AR, Rosenthal A (1991) Repair of tetralogy of Fallot in infancy. Effect of pulmonary artery size on outcome. Circulation 84:III206–III212

    CAS  PubMed  Google Scholar 

  27. Ramsay JM, Macartney FJ, Haworth SG (1985) Tetralogy of Fallot with major aortopulmonary collateral arteries. Br Heart J 53:167–172

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  28. Shimazaki Y, Maehara T, Blackstone EH, Kirklin JW, Bargeron LM Jr (1988) The structure of the pulmonary circulation in tetralogy of Fallot with pulmonary atresia. A quantitative cineangiographic study. J Thorac Cardiovasc Surg 95:1048–1058

    CAS  PubMed  Google Scholar 

  29. McConnell ME (1990) Echocardiography in classical tetralogy of Fallot. Semin Thorac Cardiovasc Surg 2:2–11

    CAS  PubMed  Google Scholar 

  30. Norton KI, Tong C, Glass RB, Nielsen JC (2006) Cardiac MR imaging assessment following tetralogy of Fallot repair. Radiographics 26:197–211

    Article  PubMed  Google Scholar 

  31. Chung T (2000) Assessment of cardiovascular anatomy in patients with congenital heart disease by magnetic resonance imaging. Pediatr Cardiol 21:18–26

    Article  CAS  PubMed  Google Scholar 

  32. Garson A Jr, Gillette PC, McNamara DG (1981) Propranolol: the preferred palliation for tetralogy of Fallot. Am J Cardiol 47:1098–1104

    Article  PubMed  Google Scholar 

  33. Castaneda AR, Freed MD, Williams RG, Norwood WI (1977) Repair of tetralogy of Fallot in infancy. Early and late results. J Thorac Cardiovasc Surg 74:372–381

    CAS  PubMed  Google Scholar 

  34. Castaneda AR (1990) Classical repair of tetralogy of Fallot: timing, technique, and results. Semin Thorac Cardiovasc Surg 2:70–75

    CAS  PubMed  Google Scholar 

  35. Di Donato RM, Jonas RA, Lang P, Rome JJ, Mayer JE Jr, Castaneda AR (1991) Neonatal repair of tetralogy of Fallot with and without pulmonary atresia. J Thorac Cardiovasc Surg 101:126–137

    PubMed  Google Scholar 

  36. Gustafson RA, Murray GF, Warden HE, Hill RC, Rozar GE Jr (1988) Early primary repair of tetralogy of Fallot. Ann Thorac Surg 45:235–241

    Article  CAS  PubMed  Google Scholar 

  37. Karl TR, Sano S, Pornviliwan S, Mee RB (1992) Tetralogy of Fallot: favorable outcome of nonneonatal transatrial, transpulmonary repair. Ann Thorac Surg 54:903–907

    Article  CAS  PubMed  Google Scholar 

  38. Kirklin JK, Kirklin JW, Blackstone EH, Milano A, Pacifico AD (1989) Effect of transannular patching on outcome after repair of tetralogy of Fallot. Ann Thorac Surg 48:783–791

    Article  CAS  PubMed  Google Scholar 

  39. Kirklin JW, Blackstone EH, Jonas RA, Shimazaki Y, Kirklin JK, Mayer JE Jr, Pacifico AD, Castaneda AR (1992) Morphologic and surgical determinants of outcome events after repair of tetralogy of Fallot and pulmonary stenosis. A two-institution study. J Thorac Cardiovasc Surg 103:706–723

    CAS  PubMed  Google Scholar 

  40. Kirklin JW, Blackstone EH, Kirklin JK, Pacifico AD, Aramendi J, Bargeron LM Jr (1983) Surgical results and protocols in the spectrum of tetralogy of Fallot. Ann Surg 198:251–265

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  41. Hennein HA, Mosca RS, Urcelay G, Crowley DC, Bove EL (1995) Intermediate results after complete repair of tetralogy of Fallot in neonates. J Thorac Cardiovasc Surg 109:332–342, 344, discussion 342–333

    Article  CAS  PubMed  Google Scholar 

  42. Remadevi KS, Vaidyanathan B, Francis E, Kannan BR, Kumar RK (2008) Balloon pulmonary valvotomy as interim palliation for symptomatic young infants with tetralogy of Fallot. Ann Pediatr Cardiol 1:2–7

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  43. Di Benedetto G, Tiraboschi R, Vanini V, Annecchino P, Aiazzi L, Caprioli C, Parenzan L (1981) Systemic-pulmonary artery shunt using PTFE prosthesis (Gore-Tex). Early results and long-term follow-up on 105 consecutive cases. Thorac Cardiovasc Surg 29:143–147

    Article  PubMed  Google Scholar 

  44. Bove EL, Kohman L, Sereika S, Byrum CJ, Kavey RE, Blackman MS, Sondheimer HM, Rosenthal A (1987) The modified Blalock-Taussig shunt: analysis of adequacy and duration of palliation. Circulation 76:III19–III23

    CAS  PubMed  Google Scholar 

  45. McKay R, de Leval MR, Rees P, Taylor JF, Macartney FJ, Stark J (1980) Postoperative angiographic assessment of modified Blalock-Taussig shunts using expanded polytetrafluoroethylene (Gore-Tex). Ann Thorac Surg 30:137–145

    Article  CAS  PubMed  Google Scholar 

  46. Pacifico AD, Sand ME, Bargeron LM Jr, Colvin EC (1987) Transatrial-transpulmonary repair of tetralogy of Fallot. J Thorac Cardiovasc Surg 93:919–924

    CAS  PubMed  Google Scholar 

  47. Binet JP (1988) Correction of tetralogy of Fallot with combined transatrial and pulmonary approach: experience with 184 consecutive cases. J Card Surg 3:97–102

    Article  CAS  PubMed  Google Scholar 

  48. Edmunds LH Jr, Saxena NC, Friedman S, Rashkind WJ, Dodd PF (1976) Transatrial repair of tetralogy of Fallot. Surgery 80:681–688

    PubMed  Google Scholar 

  49. Dietl CA, Torres AR, Cazzaniga ME, Favaloro RG (1989) Right atrial approach for surgical correction of tetralogy of Fallot. Ann Thorac Surg 47:546–551; discussion 551–542

    Article  CAS  PubMed  Google Scholar 

  50. Pacifico AD, Kirklin JK, Colvin EV, McConnell ME, Kirklin JW (1990) Transatrial-transpulmonary repair of tetralogy of Fallot. Semin Thorac Cardiovasc Surg 2:76–82

    CAS  PubMed  Google Scholar 

  51. Coles JG, Kirklin JW, Pacifico AD, Kirklin JK, Blackstone EH (1988) The relief of pulmonary stenosis by a transatrial versus a transventricular approach to the repair of tetralogy of Fallot. Ann Thorac Surg 45:7–10

    Article  CAS  PubMed  Google Scholar 

  52. Vida VL, Padalino MA, Maschietto N, Biffanti R, Anderson RH, Milanesi O, Stellin G (2012) The balloon dilation of the pulmonary valve during early repair of tetralogy of Fallot. Catheter Cardiovasc Interv 80:915–921

    Article  PubMed  Google Scholar 

  53. Blackstone EH, Kirklin JW, Pacifico AD (1979) Decision-making in repair of tetralogy of Fallot based on intraoperative measurements of pulmonary arterial outflow tract. J Thorac Cardiovasc Surg 77:526–532

    CAS  PubMed  Google Scholar 

  54. Naito Y, Fujita T, Manabe H, Kawashima Y (1980) The criteria for reconstruction of right ventricular outflow tract in total correction of tetralogy of Fallot. J Thorac Cardiovasc Surg 80:574–581

    CAS  PubMed  Google Scholar 

  55. Pacifico AD, Kirklin JW, Blackstone EH (1977) Surgical management of pulmonary stenosis in tetralogy of Fallot. J Thorac Cardiovasc Surg 74:382–395

    CAS  PubMed  Google Scholar 

  56. Kavey RE, Bove EL, Byrum CJ, Blackman MS, Sondheimer HM (1987) Postoperative functional assessment of a modified surgical approach to repair of tetralogy of Fallot. J Thorac Cardiovasc Surg 93:533–538

    CAS  PubMed  Google Scholar 

  57. Shanley CJ, Lupinetti FM, Shah NL, Beekman RH 3rd, Crowley DC, Bove EL (1993) Primary unifocalization for the absence of intrapericardial pulmonary arteries in the neonate. J Thorac Cardiovasc Surg 106:237–247

    CAS  PubMed  Google Scholar 

  58. Shimazaki Y, Blackstone EH, Kirklin JW, Jonas RA, Mandell V, Colvin EV (1992) The dimensions of the right ventricular outflow tract and pulmonary arteries in tetralogy of Fallot and pulmonary stenosis. J Thorac Cardiovasc Surg 103:692–705

    CAS  PubMed  Google Scholar 

  59. Nakata S, Imai Y, Takanashi Y, Kurosawa H, Tezuka K, Nakazawa M, Ando M, Takao A (1984) A new method for the quantitative standardization of cross-sectional areas of the pulmonary arteries in congenital heart diseases with decreased pulmonary blood flow. J Thorac Cardiovasc Surg 88:610–619

    CAS  PubMed  Google Scholar 

  60. Pagani FD, Cheatham JP, Beekman RH 3rd, Lloyd TR, Mosca RS, Bove EL (1995) The management of tetralogy of Fallot with pulmonary atresia and diminutive pulmonary arteries. J Thorac Cardiovasc Surg 110:1521–1532; discussion 1532–1523

    Article  CAS  PubMed  Google Scholar 

  61. Kirklin JW, Blackstone EH, Shimazaki Y, Maehara T, Pacifico AD, Kirklin JK, Bargeron LM Jr (1988) Survival, functional status, and reoperations after repair of tetralogy of Fallot with pulmonary atresia. J Thorac Cardiovasc Surg 96:102–116

    CAS  PubMed  Google Scholar 

  62. Clarke DR, Campbell DN, Pappas G (1989) Pulmonary allograft conduit repair of tetralogy of Fallot. An alternative to transannular patch repair. J Thorac Cardiovasc Surg 98:730–736; discussion 736–737

    CAS  PubMed  Google Scholar 

  63. Snir E, de Leval MR, Elliott MJ, Stark J (1991) Current surgical technique to repair Fallot’s tetralogy with absent pulmonary valve syndrome. Ann Thorac Surg 51:979–982

    Article  CAS  PubMed  Google Scholar 

  64. Hraska V (2005) Repair of tetralogy of Fallot with absent pulmonary valve using a new approach. Semin Thorac Cardiovasc Surg Pediatr Card Surg Annu 8:132–134

    Article  Google Scholar 

  65. Hraska V, Kantorova A, Kunovsky P, Haviar D (2002) Intermediate results with correction of tetralogy of Fallot with absent pulmonary valve using a new approach. Eur J Cardiothorac Surg 21:711–714; discussion 714–715

    Article  PubMed  Google Scholar 

  66. McDonnell BE, Raff GW, Gaynor JW, Rychik J, Godinez RI, DeCampli WM, Spray TL (1999) Outcome after repair of tetralogy of Fallot with absent pulmonary valve. Ann Thorac Surg 67:1391–1395; discussion 1395–1396

    Article  CAS  PubMed  Google Scholar 

  67. Ilbawi M, Cua C, DeLeon S, Muster A, Paul M, Cutilletta A, Arcilla R, Idriss F (1990) Repair of complete atrioventricular septal defect with tetralogy of Fallot. Ann Thorac Surg 50:407–412

    Article  CAS  PubMed  Google Scholar 

  68. Oechslin EN, Harrison DA, Harris L, Downar E, Webb GD, Siu SS, Williams WG (1999) Reoperation in adults with repair of tetralogy of Fallot: indications and outcomes. J Thorac Cardiovasc Surg 118:245–251

    Article  CAS  PubMed  Google Scholar 

  69. Hoffman TM, Wernovsky G, Atz AM, Kulik TJ, Nelson DP, Chang AC, Bailey JM, Akbary A, Kocsis JF, Kaczmarek R, Spray TL, Wessel DL (2003) Efficacy and safety of milrinone in preventing low cardiac output syndrome in infants and children after corrective surgery for congenital heart disease. Circulation 107:996–1002

    Article  CAS  PubMed  Google Scholar 

  70. Cullen S, Shore D, Redington A (1995) Characterization of right ventricular diastolic performance after complete repair of tetralogy of Fallot. Restrictive physiology predicts slow postoperative recovery. Circulation 91:1782–1789

    Article  CAS  PubMed  Google Scholar 

  71. Rajagopal SK, Thiagarajan RR (2011) Perioperative care of children with tetralogy of Fallot. Curr Treat Options Cardiovasc Med 13:464–474

    Article  PubMed  Google Scholar 

  72. Plumpton K, Justo R, Haas N (2005) Amiodarone for post-operative junctional ectopic tachycardia. Cardiol Young 15:13–18

    Article  PubMed  Google Scholar 

  73. Hoffman TM, Bush DM, Wernovsky G, Cohen MI, Wieand TS, Gaynor JW, Spray TL, Rhodes LA (2002) Postoperative junctional ectopic tachycardia in children: incidence, risk factors, and treatment. Ann Thorac Surg 74:1607–1611

    Article  PubMed  Google Scholar 

  74. Manrique AM, Arroyo M, Lin Y, El Khoudary SR, Colvin E, Lichtenstein S, Chrysostomou C, Orr R, Jooste E, Davis P, Wearden P, Morell V, Munoz R (2010) Magnesium supplementation during cardiopulmonary bypass to prevent junctional ectopic tachycardia after pediatric cardiac surgery: a randomized controlled study. J Thorac Cardiovasc Surg 139:162–169 e162

    Article  CAS  PubMed  Google Scholar 

  75. Hirsch JC, Mosca RS, Bove EL (2000) Complete repair of tetralogy of Fallot in the neonate: results in the modern era. Ann Surg 232:508–514

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  76. Park CS, Lee JR, Lim HG, Kim WH, Kim YJ (2010) The long-term result of total repair for tetralogy of Fallot. Eur J Cardiothorac Surg 38:311–317

    Article  PubMed  Google Scholar 

  77. Knott-Craig CJ, Elkins RC, Lane MM, Holz J, McCue C, Ward KE (1998) A 26-year experience with surgical management of tetralogy of Fallot: risk analysis for mortality or late reintervention. Ann Thorac Surg 66:506–511

    Article  CAS  PubMed  Google Scholar 

  78. Murphy JG, Gersh BJ, Mair DD, Fuster V, McGoon MD, Ilstrup DM, McGoon DC, Kirklin JW, Danielson GK (1993) Long-term outcome in patients undergoing surgical repair of tetralogy of Fallot. N Engl J Med 329:593–599

    Article  CAS  PubMed  Google Scholar 

  79. Nollert G, Fischlein T, Bouterwek S, Bohmer C, Klinner W, Reichart B (1997) Long-term survival in patients with repair of tetralogy of Fallot: 36-year follow-up of 490 survivors of the first year after surgical repair. J Am Coll Cardiol 30:1374–1383

    Article  CAS  PubMed  Google Scholar 

  80. Bove EL, Byrum CJ, Thomas FD, Kavey RE, Sondheimer HM, Blackman MS, Parker FB Jr (1983) The influence of pulmonary insufficiency on ventricular function following repair of tetralogy of Fallot. Evaluation using radionuclide ventriculography. J Thorac Cardiovasc Surg 85:691–696

    CAS  PubMed  Google Scholar 

  81. Burchill LJ, Wald RM, Harris L, Colman JM, Silversides CK (2011) Pulmonary valve replacement in adults with repaired tetralogy of Fallot. Semin Thorac Cardiovasc Surg Pediatr Card Surg Annu 14:92–97

    Article  PubMed  Google Scholar 

  82. Therrien J, Siu SC, McLaughlin PR, Liu PP, Williams WG, Webb GD (2000) Pulmonary valve replacement in adults late after repair of tetralogy of Fallot: are we operating too late? J Am Coll Cardiol 36:1670–1675

    Article  CAS  PubMed  Google Scholar 

  83. Frigiola A, Tsang V, Bull C, Coats L, Khambadkone S, Derrick G, Mist B, Walker F, van Doorn C, Bonhoeffer P, Taylor AM (2008) Biventricular response after pulmonary valve replacement for right ventricular outflow tract dysfunction: is age a predictor of outcome? Circulation 118:S182–S190

    Article  PubMed  Google Scholar 

  84. Ilbawi MN, Idriss FS, DeLeon SY, Muster AJ, Gidding SS, Berry TE, Paul MH (1987) Factors that exaggerate the deleterious effects of pulmonary insufficiency on the right ventricle after tetralogy repair. Surgical implications. J Thorac Cardiovasc Surg 93:36–44

    CAS  PubMed  Google Scholar 

  85. Yemets IM, Williams WG, Webb GD, Harrison DA, McLaughlin PR, Trusler GA, Coles JG, Rebeyka IM, Freedom RM (1997) Pulmonary valve replacement late after repair of tetralogy of Fallot. Ann Thorac Surg 64:526–530

    Article  CAS  PubMed  Google Scholar 

  86. Knauth AL, Gauvreau K, Powell AJ, Landzberg MJ, Walsh EP, Lock JE, del Nido PJ, Geva T (2008) Ventricular size and function assessed by cardiac MRI predict major adverse clinical outcomes late after tetralogy of Fallot repair. Heart 94:211–216

    Article  CAS  PubMed  Google Scholar 

  87. Lurz P, Bonhoeffer P, Taylor AM (2009) Percutaneous pulmonary valve implantation: an update. Expert Rev Cardiovasc Ther 7:823–833

    Article  PubMed  Google Scholar 

  88. McElhinney DB, Hellenbrand WE, Zahn EM, Jones TK, Cheatham JP, Lock JE, Vincent JA (2010) Short- and medium-term outcomes after transcatheter pulmonary valve placement in the expanded multicenter us melody valve trial. Circulation 122:507–516

    Article  PubMed  PubMed Central  Google Scholar 

  89. Hirsch JC, Bove EL (2003) Tetralogy of Fallot. In: Mavroudis C, Backer CL (eds) Pediatric cardiac surgery, 3rd edn. Mosby, Philadelphia

    Google Scholar 

  90. Geva T (2011) Repaired tetralogy of Fallot: the roles of cardiovascular magnetic resonance in evaluating pathophysiology and for pulmonary replacement decision support. J Cardiov Magn Reson 13(9)

    Google Scholar 

  91. Ammash NM, Dearani JA, Burkhart HM et al. (2007) Pulmonary regurgitation after tetralogy of Fallot repair: clinical features, sequelae, and timing of pulmonary valve replacement. Congenital Heart Dis 2(6):386–403

    Article  Google Scholar 

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Authors and Affiliations

  1. Department of Cardiac Surgery, University of Michigan Medical School, Ann Arbor, MI, USA

    Jennifer S. Nelson, Edward L. Bove & Jennifer C. Hirsch-Romano

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  1. Jennifer S. Nelson
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  2. Edward L. Bove
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  3. Jennifer C. Hirsch-Romano
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Correspondence to Jennifer S. Nelson .

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  1. Dept. of Pediatric Cardiology, Children's Hospital Colorado, Univ. of Colorado, Denver, Aurora, Colorado, USA

    Eduardo M. Da Cruz

  2. Dept. Pediatric Cardiology, Children's Hospital Colorado, Univ. of Colorado, Denver, Aurora, Colorado, USA

    Dunbar Ivy

  3. Pediatric Cardiac Surgery, Children's Hospital Colorado, Univ. of Colorado, Denver, Aurora, Colorado, USA

    James Jaggers

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Nelson, J.S., Bove, E.L., Hirsch-Romano, J.C. (2014). Tetralogy of Fallot. In: Da Cruz, E., Ivy, D., Jaggers, J. (eds) Pediatric and Congenital Cardiology, Cardiac Surgery and Intensive Care. Springer, London. https://doi.org/10.1007/978-1-4471-4619-3_18

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