Tetralogy of Fallot/surgery

ABC

Editorial

The Challenge of Echocardiography in the Accurate Assessment of the Right Ventricle and Pulmonary Insufficiency

The current recognition of the importance of the right ventricle (RV) role in the evolution and prognosis of various cardiovascular conditions is indisputable and the proper assessment of its dimension and function has a direct impact on clinical management.

Pulmonary insufficiency (PI) is common after tetralogy of Fallot repair (POTF) and approach of congenital heart disease with pulmonary obstruction, being is an important determinant of outcome due to its consequences, causing RV dilation and dysfunction, exercise intolerance, increased risk of arrhythmias and sudden death.

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IJCS

Case Report

Concordance of Congenital Heart Defect in Monozygotic Twins in Brazil

Adail Orrith Liborio Neto et al. Aline Reis Bereta

Abstract

Tetralogy of Fallot (TOF) consists of four cardiac changes: interventricular communication, pulmonary stenosis, aortic dextroposition and right ventricular hypertrophy. The prevalence is 0.1 per 1,000 live births. A primiparous mother with gestational age of 38 weeks came to the emergency. At the time, it was verified in her twin pregnancy that one fetus had TOF, thus a pregnancy interruption was scheduled for the following day. In the neonatal physical examination of both, localized acrocyanosis, regular heart rhythm with the presence of a heart murmur, and good peripheral perfusion were found. The echocardiogram of twin 1 revealed: patent foramen ovale; a wide perimembranous interventricular communication of misalignment, with the aorta riding the septum by 50%; hypertrophied and long infundibulum with pulmonary infundibulo-valvular stenosis, with a maximum systolic gradient of 66 mm Hg; both pulmonary arteries presented dimensions of 0.35 mm; pulmonary valve annulus: 0.56 mm; and patent ductus arteriosus measuring 0.19 mm. The echocardiogram of twin 2 showed: patent foramen ovale; a wide perimembranous interventricular communication of misalignment, with the aorta riding the septum by 50%; hypertrophied infundibulum with stenosis pulmonary infundibulo-valve, with a maximum systolic gradient of 33 mm Hg; reduced confluent pulmonary arteries; right pulmonary artery measuring 0.40 mm and left pulmonary artery measuring 0.55 mm; pulmonary valve annulus measuring 0.72 mm; a closed arterial canal, and mild aortic regurgitation. Tetralogy of Fallot is a multifaceted syndrome with a high prevalence in pediatrics. This case is the first case of congenital heart defect concordance for TOF in monozygotic twins in Brazil.

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IJCS

Case Report

Improvement of Pacing-Induced Dyssynchrony by Right Ventricular Septal Stimulation in a Child with Tetralogy of Fallot

Alexander González Guillen et al. Michel Cabrera Ortega Francisco Díaz Ramírez Dunia Bárbara Benítez Ramos

Introduction

Complete atrioventricular block (CAVB) is not an uncommon complication after surgical correction of tetralogy of Fallot (TOF). The choice of the ventricular pacing site in patients requiring pacemaker therapy depends on factors such as age, weight, presence of a venous anomaly, and intracardiac short -circuit. The harmful effects of ventricular pacing are most pronounced during right ventricular (RV) stimulation. Even then, RV pacing sites have been determined to be optimal in some patients with and without congenital heart disease.

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The Challenge of Echocardiography in the Accurate Assessment of the Right Ventricle and Pulmonary Insufficiency

Concordance of Congenital Heart Defect in Monozygotic Twins in Brazil

Abstract

Improvement of Pacing-Induced Dyssynchrony by Right Ventricular Septal Stimulation in a Child with Tetralogy of Fallot

Introduction

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