The Experts below are selected from a list of 303 Experts worldwide ranked by ideXlab platform
Robert M. Freedom - One of the best experts on this subject based on the ideXlab platform.
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Tetralogy of Fallot with non confluent pulmonary arteries and aortopulmonary septal defect
Cardiology in The Young, 1999Co-Authors: Anne I Dipchand, Michael Giuffre, Robert M. FreedomAbstract:: Aortopulmonary septal defect and Tetralogy of Fallot is a rare combination. We report a case of Tetralogy of Fallot, non-confluent pulmonary arteries with the left arising from the arterial duct, and a large aortopulmonary septal defect diagnosed by echocardiogram and confirmed by cardiac catheterization.
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pulmonary valve replacement late after repair of Tetralogy of Fallot
The Annals of Thoracic Surgery, 1997Co-Authors: Ilya Yemets, Gary D. Webb, William G Williams, David A Harrison, Peter R Mclaughlin, George A Trusler, John G Coles, Ivan M Rebeyka, Robert M. FreedomAbstract:Background. Pulmonary valve incompetence is usually well tolerated after Tetralogy of Fallot repair but may result in late progressive right heart failure as manifested by increasing fatigue, dyspnea, and frequently arrhythmias. Methods. All patients who underwent pulmonary valve replacement in our center late after repair of Tetralogy of Fallot were reviewed. Results. Eighty-five patients had elective pulmonary valve replacement late (median, 9.3 years) after repair. Operative risk was low (1.1%). Ninety percent of survivors are in New York Heart Association class I. Survival 10 years after pulmonary valve replacement is 95%, with 86% of the patients free of reoperation for valve failure. Conclusions. Pulmonary valve replacement is infrequently required after repair of Tetralogy of Fallot. Pulmonary valve replacement may be performed electively with little risk; it improves symptoms of right heart failure and provides satisfactory long-term survival with low risk of early valve failure. As the population of patients who have had repair of Tetralogy of Fallot ages, pulmonary valve replacement will become a more frequent consideration.
Michel Noutsias - One of the best experts on this subject based on the ideXlab platform.
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Cardiovascular imaging approach in pre and postoperative Tetralogy of Fallot
BMC Cardiovascular Disorders, 2019Co-Authors: Sotiria C. Apostolopoulou, Athanassios Manginas, Nikolaos L. Kelekis, Michel NoutsiasAbstract:Advances in the medical and surgical management of Tetralogy of Fallot have led to marked increase of the number and age of survivors. Imaging in patients with Tetralogy of Fallot plays a crucial role in the diagnosis and follow up, and essentially guides management and intervention in this entity. This study systematically reviews the imaging modalities used in patients with Tetralogy of Fallot in the evaluation of preoperative and postoperative anatomic and hemodynamic lesions, as well as disease progression in this diagnosis. Various invasive and noninvasive imaging modalities, most commonly echocardiography and cardiovascular magnetic resonance, computed tomography and angiocardiography provide the imaging information required for diagnosis, management and follow up in Tetralogy of Fallot. The choice of the appropriate imaging tool or their combination is guided by the clinical question, the patient’s clinical condition and contraindications as well as the strengths and weaknesses of each imaging modality. Tetralogy of Fallot is the most common complex congenital heart disease with long term survivors that need close follow up and complicated management, including multiple surgical and transcatheter interventions. Knowledge of the role and protocols of imaging in Tetralogy of Fallot is extremely important for the clinical as well as the imaging physician in order to optimize patients’ management and long-term prognosis.
Ryuji Tominaga - One of the best experts on this subject based on the ideXlab platform.
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Pulmonary valve replacement long after repair of Tetralogy of Fallot
General Thoracic and Cardiovascular Surgery, 2012Co-Authors: Yuichi Shiokawa, Hiromichi Sonoda, Yoshihisa Tanoue, Takahiro Nishida, Atsuhiro Nakashima, Ryuji TominagaAbstract:Purpose Pulmonary valve replacement long after repair of Tetralogy of Fallot can improve cardiac function, functional status, and arrhythmia propensity. This has not been reported in Japan. We aim to evaluate the effects of pulmonary valve replacement in repaired Tetralogy of Fallot. Methods Nineteen patients underwent pulmonary valve replacement after repair of Tetralogy of Fallot, excluding Rastelli type operation, between August 1981 and August 2011. The results of the pulmonary valve replacement were assessed by analyzing preoperative and postoperative cardiothoracic ratio, cardiac function, functional status, QRS duration and durability of the prosthetic valves. Results There were neither operative nor late deaths. The Cardiothoracic ratio significantly improved from 61.0 ± 5.2 % preoperatively to 56.2 ± 4.8 % postoperatively ( P
Koichiro Niwa - One of the best experts on this subject based on the ideXlab platform.
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Tetralogy of Fallot and Pulmonary Atresia with Ventricular Septal Defect
Aortopathy, 2017Co-Authors: Koichiro NiwaAbstract:Aortic dilatation and regurgitation in unrepaired Tetralogy of Fallot imposes volume overload on both ventricles. A significant subset of adults late after repair of Tetralogy of Fallot exhibits progressive aortic root dilatation, which may lead to aortic regurgitation and predispose to dissection and rupture that can be fatal, and necessitating aortic valve and aortic root surgery. The aortic dilatation relates medial abnormalities coupled with previous long-standing volume overload of the ascending aorta. Risk factors for aortic dilatation and regurgitation in Tetralogy of Fallot relate to specific hemodynamic abnormalities, such as pulmonary atresia, right aortic arch, and a history of an aortopulmonary shunt, and patient demographics such as male sex and the association of chromosome 22q11 deletion. There is no current consensus on beta-blocker or angiotensin II receptor blocker (ARB) administration for limiting progressive dilatation of the aortic root in patients with repaired Tetralogy of Fallot. Aortic root surgery should be considered for these patients and address aortic regurgitation and/or prevent the risk of aortic dissection. Thus, in Tetralogy of Fallot meticulous follow-up of the aortic root after repair is recommended.
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Aortic root dilatation in Tetralogy of Fallot long-term after repair--histology of the aorta in Tetralogy of Fallot: evidence of intrinsic aortopathy.
International Journal of Cardiology, 2005Co-Authors: Koichiro NiwaAbstract:Abstract The ascending aorta or pulmonary trunk in congenital heart disease may dilate out of proportion to hemodynamic or morphogenetic expectations, may become aneurysmal, and may rupture. A bicuspid aortic valve and/or coarctation of the aorta are consistently associated with ascending aortic and para-coarctation medial abnormalities. Congenital heart diseases such as single ventricle, truncus arteriosus, transposition of the great arteries and Tetralogy of Fallot are also associated with aortic medial abnormalities. Aortic regurgitation in unrepaired Tetralogy of Fallot imposes volume overload on both ventricles. A significant subset of adults late after repair of Tetralogy of Fallot exhibits progressive aortic root dilatation which may lead to regurgitation and predispose to dissection and rupture which can be fatal, and necessitating aortic valve and aortic root surgery. The aortic dilatation relates medial abnormalities coupled with previous long-standing volume overload of the ascending aorta. Risk factors for aortic dilatation and regurgitation in Tetralogy of Fallot relate to specific hemodynamic abnormalities such as pulmonary atresia, right aortic arch and a history of an aorto-pulmonary shunt, and patient demographics such as male sex and the association of chromosome 22q11 deletion. There is no current consensus on β-blocker administration for limiting progressive dilatation of the aortic root in patients with congenital heart disease and repaired Tetralogy of Fallot. Aortic root surgery should be considered for these patients and address aortic regurgitation and or prevent the risk of aortic dissection. Meticulous follow-up of the aortic root after repair, Tetralogy of Fallot are thus recommended.
Ilya Yemets - One of the best experts on this subject based on the ideXlab platform.
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pulmonary valve replacement late after repair of Tetralogy of Fallot
The Annals of Thoracic Surgery, 1997Co-Authors: Ilya Yemets, Gary D. Webb, William G Williams, David A Harrison, Peter R Mclaughlin, George A Trusler, John G Coles, Ivan M Rebeyka, Robert M. FreedomAbstract:Background. Pulmonary valve incompetence is usually well tolerated after Tetralogy of Fallot repair but may result in late progressive right heart failure as manifested by increasing fatigue, dyspnea, and frequently arrhythmias. Methods. All patients who underwent pulmonary valve replacement in our center late after repair of Tetralogy of Fallot were reviewed. Results. Eighty-five patients had elective pulmonary valve replacement late (median, 9.3 years) after repair. Operative risk was low (1.1%). Ninety percent of survivors are in New York Heart Association class I. Survival 10 years after pulmonary valve replacement is 95%, with 86% of the patients free of reoperation for valve failure. Conclusions. Pulmonary valve replacement is infrequently required after repair of Tetralogy of Fallot. Pulmonary valve replacement may be performed electively with little risk; it improves symptoms of right heart failure and provides satisfactory long-term survival with low risk of early valve failure. As the population of patients who have had repair of Tetralogy of Fallot ages, pulmonary valve replacement will become a more frequent consideration.
