Late problems in tetralogy of Fallot--recognition, management, and prevention.
Most adults with previous repair of tetralogy of Fallot lead unrestricted lives and are asymptomatic. Residual RVOT problems such as significant PR and/or RVOT obstruction however are common and often lead to gradual RV dilation and dysfunction with consequent supraventricular or ventricular arrhythmias. Hemodynamic causes for the tachyarrhythmia should be sought and corrected, and therapy directed towards suppressing the arrhythmia (antiarrhythmics, cryoablation or AICD) should be carried out as well. Recent changes in the surgical approaches to the repair of tetralogy at the time initial repair may well translate into a reduced incidence of late complications.
Therrien
Judith
J
Toronto General Hospital, 200 Elizabeth Street, 12 EN Room 213, University of Toronto, Ontario, M5G 2C4, Canada. judith.therrien@uhn.on.ca
Marx
Gerald Ross
GR
Gatzoulis
Michael A
MA
D000328:Adult; D013504:Cardiovascular Surgical Procedures / Q000009:adverse effects / Q000379:methods; D002675:Child, Preschool; D005260:Female; D005817:Genetic Counseling / Q000379:methods; D006331:Heart Diseases / Q000209:etiology; D006801:Humans; D008297:Male; D011183:Postoperative Complications; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular / Q000517:prevention & control*; D013771:Tetralogy of Fallot / Q000150:complications / Q000175:diagnosis* / Q000517:prevention & control / Q000601:surgery*; D013997:Time Factors