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Heart failure in adult congenital heart disease: tetralogy of Fallot

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Abstract

The number of rTOF patients who survive into adulthood is steadily rising, with currently more than 90% reaching the third decade of life. However, rTOF patients are not cured, but rather have a lifelong increased risk for cardiac and non-cardiac complications. Heart failure is recognized as a significant complication. Its occurrence is strongly associated with adverse outcome. Unfortunately, conventional concepts of heart failure may not be directly applicable in this patient group. This article presents a review of the current knowledge on HF in rTOF patients, including incidence and prevalence, the most common mechanisms of heart failure, i.e., valvular pathologies, shunt lesions, left atrial hypertension, primary left heart and right heart failure, arrhythmias, and coronary artery disease. In addition, we will review information regarding extracardiac complications, risk factors for the development of heart failure, clinical impact and prognosis, and assessment possibilities, particularly of the right ventricle, as well as management strategies. We explore potential future concepts that may stimulate further research into this field.

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Authors and Affiliations

  1. Division of Cardiology, Department of Medicine, New York Presbyterian Hospital-Weill Cornell Medicine, New York, NY, USA

    Anna S. Mueller, Daniel M. McDonald, Harsimran S. Singh & Jonathan N. Ginns

  2. Division of Cardiology at Weill Cornell Medical Center, Starr Pavilion, 520 East 70th Street, Starr Pavilion, 4th Floor, New York, NY, 1002, USA

    Jonathan N. Ginns

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  1. Anna S. Mueller
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  2. Daniel M. McDonald
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Mueller, A.S., McDonald, D.M., Singh, H.S. et al. Heart failure in adult congenital heart disease: tetralogy of Fallot. Heart Fail Rev 25, 583–598 (2020). https://doi.org/10.1007/s10741-019-09903-0

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