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Exercise Physiology for the Pediatric and Congenital Cardiologist pp 83–95Cite as

Repaired Tetralogy of Fallot

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Abstract

While a substantial minority of patients with repaired tetralogy of Fallot (rTOF) have normal exercise performance, as a group their performance is mild-moderately decreased, and there is a cohort with markedly decreased exercise capacity. The factors responsible for the rTOF patient’s exercise intolerance are probably diverse and may vary from patient to patient. In most cases, residual cardiovascular lesions (pulmonary stenosis, pulmonary regurgitation, and especially right ventricular dysfunction) are the most important issues. The dynamic interplay between these variables and their effect on exercise function is complex, however, and can vary over time. The combination of an incompetent pulmonary valve and residual pulmonary artery stenoses is particularly deleterious and results in interesting physiology that is uniquely appreciated in the exercise physiology laboratory. Exercise testing can be safely performed in a wide range of TOF patients. Data from exercise testing in rTOF patients has important prognostic and clinical implications.

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Author information

Authors and Affiliations

  1. Department of Pediatrics, Harvard Medical School, Boston, MA, USA

    Jonathan Rhodes, Alexander R. Opotowsky & Mark E. Alexander

  2. Department of Cardiology, Boston Children’s Hospital, Boston, MA, USA

    Jonathan Rhodes & Alexander R. Opotowsky

  3. Division of Cardiovascular Medicine, Department of Medicine, Brigham and Women’s Hospital, Boston, MA, USA

    Alexander R. Opotowsky

  4. Exercise Physiology Laboratory, Department of Cardiology, Boston Children’s Hospital, Boston, MA, USA

    Alexander R. Opotowsky

  5. Exercise Physiology, Arrhythmia Service, Department of Cardiology, Boston Children’s Hospital, Boston, MA, USA

    Mark E. Alexander

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  1. Jonathan Rhodes
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Correspondence to Jonathan Rhodes .

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Editors and Affiliations

  1. Department of Pediatrics, Harvard Medical School, Boston, MA, USA

    Jonathan Rhodes

  2. Department of Pediatrics, Harvard Medical School, Boston, MA, USA

    Mark E. Alexander

  3. Department of Pediatrics, Harvard Medical School, Boston, MA, USA

    Alexander R. Opotowsky

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Rhodes, J., Opotowsky, A.R., Alexander, M.E. (2019). Repaired Tetralogy of Fallot. In: Rhodes, J., Alexander, M., Opotowsky, A. (eds) Exercise Physiology for the Pediatric and Congenital Cardiologist. Springer, Cham. https://doi.org/10.1007/978-3-030-16818-6_14

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  • DOI: https://doi.org/10.1007/978-3-030-16818-6_14

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-16817-9

  • Online ISBN: 978-3-030-16818-6

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