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Unusual Cardiac Associations with Tetralogy of Fallot—A Descriptive Study

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Abstract

We present a large single-center series (>2200 cases) operated for Tetralogy of Fallot (TOF). We analyzed the incidence of associated unusual and uncommonly described cardiac lesions and their diagnostic and therapeutic implications in TOF patients. This retrospective study was conducted by reviewing records of patients operated for TOF at a large tertiary care pediatric cardiac centre. From 2002 to 2008, a total of 2235 cases of TOF were evaluated with echocardiography, cardiac catheterization, and/or cardiac computed tomography followed by cardiac surgery. Known and well-described associations were excluded from the study. Unusual associations were tabulated. Several unusual associations having an incidence >0.1% were detected. These included subaortic membrane (1%), pulmonary venous abnormalities (0.5%), small left ventricle (0.5%), interrupted inferior vena cava (0.5%), mitral valve abnormalities (0.4%), hemitruncus (0.4%), tricuspid valve abnormalities (0.4%), biventricular dysfunction (0.3%), retroaortic innominate vein (0.3%), bicuspid aortic valve (0.2%), and pericardial effusion (0.2%). This series describes unusual, not previously routinely reported cardiac lesions associated with TOF that may affect management and should be sought on preoperative evaluation. We demonstrate that more unusual associations do exist in not infrequent numbers, i.e., a TET is not just a TET.

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References

  1. Abid A, Dhiab M, Fehri W (2006) A rare association: Tetralogy of Fallot and Ebstein’s anomaly. Arch Mal Couer Vaiss 99:77–79

    CAS  Google Scholar 

  2. Adnan C, Jess MS (2002) Total correction of Tetralogy of Fallot in the first year of life: late results. Ann Thorac Surg 74:133–138

    Article  Google Scholar 

  3. Andrew NR, Joseph R, Elliot AS, Michael LR (1990) Tetralogy of Fallot with anomalous pulmonary venous connections: a rare but clinically important association. Br Heart J 64:325–328

    Article  Google Scholar 

  4. Carano N, Piazza P, Agnetti A, Squarcia U (1997) Congenital pulmonary steal phenomenon associated with tetralogy of fallot, right aortic arch, and isolation of the left subclavian artery. Pediatr Cardiol 18:57–60

    Article  CAS  PubMed  Google Scholar 

  5. Chandrakant RP, Grace LS, John RL (2007) Tetralogy of Fallot with an aortopulmonary septal defect. J Ultrasound Med 26:1115–1117

    Google Scholar 

  6. Cheemalapati SK, Gangireddy VR, Mohan D, Nanda KP (2008) Tetralogy of Fallot with rheumatic mitral stenosis: a case report. J Med Case Rep 2:127–128

    Article  Google Scholar 

  7. David SM, Daniel JD, Wesley V, Charles DF, McKenzie ED (2005) Tetralogy of Fallot and hypoplastic aortic arch: a novel perspective. J Thorac Cardiovasc Surg 129:1448–1450

    Article  Google Scholar 

  8. Geva T, Sandweiss BM, Gauvreau K, Lock JE, Powell AJ (2004) Factors associated with impaired clinical status in long-term survivors of Tetralogy of Fallot repair evaluated by magnetic resonance imaging. J Am Coll Cardiol 43:1068–1074

    Article  PubMed  Google Scholar 

  9. Hani KN, Neerod KJ, Michael G, Mansour AM, Ahmed IR, Tarek M (2007) Pulmonary atresia, VSD in association with coronary-pulmonary artery fistula. Asian Cardiovasc Thorac Ann 15:335–338

    Google Scholar 

  10. Inderjit SV, Barry RK, Darryl FS, James LM (1987) Surgical management in Tetralogy of Fallot and vascular ring. Pediatr Cardiol 8:131–134

    Article  Google Scholar 

  11. Joelle G, Kenneth AM, Henry RW, William IN (1992) Tetralogy of Fallot and coarctation of the aorta: a rare combination and its clinical implications. J Pediatr Cardiol 13:37–40

    Google Scholar 

  12. Karim D, Randy R, Ernerio A (2009) Tetralogy of Fallot associated with left hemitruncus: case report and findings by cardiac computed tomography. Cong Cardiol Today 7:1–4

    Google Scholar 

  13. Lewin MB, Towbin JA, Thapar MK, Dreyer WJ, Feltes TF (1997) The rare association of Tetralogy of Fallot with hypertrophic cardiomyopathy. Report of 2 neonatal patients. Tex Heart Inst J 24:215–217

    CAS  PubMed  Google Scholar 

  14. McConnell ME, Pacifico AD, Johnson WH, Mroczek E (1994) Progressive pulmonary venous obstruction and pulmonary interstitial fibrosis associated with Tetralogy of Fallot. Pediatr Cardiol 15:95–99

    CAS  PubMed  Google Scholar 

  15. Ming RC, Chang-Hsien YU (2002) Subclavian and pulmonary steal phenomenon in isolated left subclavian artery with left lung agenesis. Jpn Heart J 43:429–432

    Article  Google Scholar 

  16. Olivier YG, Philippe MC, Bruce JC, Richard VP, Dominique M (2002) Tetralogy of Fallot with aortic valvular stenosis: surgical correction in one case. Ann Thorac Surg 73:967–969

    Article  Google Scholar 

  17. Perry LW, Neill CA, Ferencz C, Rubin JD, Loffredo CA (1993) Infants with congenital heart disease: the cases. In: Ferencz C, Rubin JD, Loffredo CA et al (eds) Perspectives in pediatric cardiology. Epidemiology of congenital heart disease: the Baltimore–Washington infant study, 1981–1989. Futura, Armonk, NY, pp 33–62

    Google Scholar 

  18. Rajaram PC, Lakshmikanathan, Thanikachalam S, Vaidyanathan S, Subramanyan N (2005) Plain radiographic anticipation of adequacy of left ventricular size in patients with Tetralogy of Fallot by studying the level of diaphragmatic domes a new sign. A catheter correlated study of hundred patients. Indian J Radiol Imaging 15:99–102

    Article  Google Scholar 

  19. Ritesh BS, Suresh PV, Neeraj A, Sunita M (2008) When to suspect an aortopulmonary window in a pink Tetralogy of Fallot. Indian Heart J 60:146–148

    Google Scholar 

  20. Sanders JH, Richard VP, Sade RM (1976) Tetralogy of Fallot with discrete fibrous subaortic stenosis. Chest 69:543–544

    Article  CAS  PubMed  Google Scholar 

  21. Sheila JC, David S, Welton MG (2004) Preoperative diagnosis of co-existing divided left atrium and Tetralogy of Fallot. Cardiol Young 14:456–459

    Article  Google Scholar 

  22. Snehal K, Sreepal J, Pankaj K, Swati G, Suresh J (2008) Retroaortic innominate vein―incidence, association with congenital heart defects, embryology and clinical significance. Ann Pediatr Card 1:139–141

    Article  Google Scholar 

  23. Topaz O (1986) Myocardial calcifications in infants with congenital heart disease. Pediatr Cardiol 7:75–78

    Article  CAS  PubMed  Google Scholar 

  24. Victor OM, Mariano F, Seamus C, Martin JE (1998) Anomalous coronary artery with Tetralogy of Fallot and aortopulmonary window. Ann Thorac Surg 66:1403–1405

    Article  Google Scholar 

  25. Watson DG, Smith JC, Warren ET (1997) Congestive heart failure with Tetralogy of Fallot relieved by an aortopulmonary shunt. Pediatr Cardiol 18:381–384

    Article  CAS  PubMed  Google Scholar 

  26. Yukihiro K, Hideo O, Nobuhiro N, Jotaro K, Arata M, Shinichi T (2001) Pulmonary atresia, ventricular septal defect and coronary-pulmonary artery fistula. Ann Thorac Surg 71:355–356

    Article  Google Scholar 

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Correspondence to Vishal Changela.

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Changela, V., John, C. & Maheshwari, S. Unusual Cardiac Associations with Tetralogy of Fallot—A Descriptive Study. Pediatr Cardiol 31, 785–791 (2010). https://doi.org/10.1007/s00246-010-9701-1

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  • DOI: https://doi.org/10.1007/s00246-010-9701-1

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