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Ventricular Arrhythmic Events After Transcatheter Pulmonary Valve Replacement in Adults with Repaired Tetralogy of Fallot

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Abstract

Arrhythmias are a major cause of morbidity and mortality in repaired Tetralogy of Fallot (rTOF). However, predicting those at risk for life-threatening ventricular arrhythmias (VA) remains difficult. Many centers approach risk assessment at the time of surgical pulmonary valve intervention. Increasing numbers of patients have undergone transcatheter pulmonary valve replacement (TPVR), yet there are no studies evaluating VA in rTOF undergoing TPVR and the approach to risk assessment for these patients. A single center retrospective study was performed. The institutional interventional database was queried to identify all adults ≥ 18 years of age with rTOF status who underwent TPVR from 2010 to 2019. A total of 81 patients with rTOF underwent TPVR from 2010 to 2019. Mean age at time of TPVR was 27 ± 13 years; follow up after TPVR was 6.4 ± 3.1 years. VA events occurred in 4 patients (5%). There was no significant difference in current era VA risk factors in rTOF patients between the VA event group and the non-VA event group. VA risk in this cohort of rTOF with TPVR was 5%, comparable to that reported in current era surgical cohort with similar follow up. Multi-center agreement on risk assessment protocol is needed for future studies.

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Funding

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

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Authors and Affiliations

  1. Division of Cardiology, Connecticut Children’s, Hartford, CT, USA

    Anudeep K. Dodeja

  2. Department of Pediatrics, Division of Cardiovascular Medicine, Nationwide Children’s Hospital, Columbus, OH, USA

    Zachary Daniels, May Ling Mah, Victoria Shay, Kan Hor, Naomi Kertesz, Curt Daniels & Anna Kamp

  3. Department of Internal Medicine, Division of Cardiovascular Medicine, The Ohio State University Wexner Medical Center, Columbus, OH, USA

    Naomi Kertesz, Curt Daniels & Anna Kamp

  4. Pediatric Biostatistics Core, Department of Pediatrics, Emory University, Atlanta, GA, USA

    Shasha Bai

  5. T3-3234, The Heart Center, Nationwide Children’s Hospital, 700 Children’s Drive, Columbus, OH, 43205, USA

    Anna Kamp

Authors
  1. Anudeep K. Dodeja
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  2. Zachary Daniels
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  3. May Ling Mah
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  4. Victoria Shay
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  5. Shasha Bai
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  6. Kan Hor
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  7. Naomi Kertesz
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  8. Curt Daniels
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  9. Anna Kamp
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Contributions

All authors contributed to the study concept and design. Data collection was performed by AKD, ZD, and VS. Data analysis was performed by SB. The first draft of the manuscript was written by AKD and AK. All authors commented on prior drafts of the manuscript and all authors approved the final manuscript.

Corresponding author

Correspondence to Anna Kamp.

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The authors declare no competing interests.

Conflict of interest

Dr. Daniels is a consultant to Medtronic. The other authors have no relevant financial or non-financial interests to disclose.

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Dodeja, A.K., Daniels, Z., Mah, M.L. et al. Ventricular Arrhythmic Events After Transcatheter Pulmonary Valve Replacement in Adults with Repaired Tetralogy of Fallot. Pediatr Cardiol 44, 1226–1231 (2023). https://doi.org/10.1007/s00246-023-03120-1

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  • DOI: https://doi.org/10.1007/s00246-023-03120-1

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