Population-based review of tetralogy of Fallot with absent pulmonary valve: is prenatal diagnosis really associated with a poor prognosis?
OBJECTIVE
Tetralogy of Fallot with absent pulmonary valve syndrome (TETAPV) is reported in obstetric literature to have an extremely poor prognosis. We sought to determine the clinical outcome associated with TETAPV and whether prenatal diagnosis confers a poor prognosis.


METHODS
All cases of TETAPV diagnosed in British Columbia between 1980 and 2009 were reviewed and grouped according to time of diagnosis, either prenatal or postnatal. The groups were compared with respect to mortality, respiratory problems, number of interventions and functional capacity at last follow-up.


RESULTS
Eight and 11 patients were included in the prenatally and postnatally diagnosed groups, with overall long-term survival of 71% and 82%, respectively. There was no significant difference in mortality, frequency of preoperative intubation, number of interventions or functional capacity between groups.


CONCLUSIONS
From a population-based retrospective analysis of TETAPV cases identified over three decades it is concluded that the prognosis for TETAPV is better than that previously reported in the obstetric literature. This information should be used to guide prenatal counseling.
Division of Cardiology, Department of Pediatrics, British Columbia Children's Hospital and University of British Columbia, Vancouver, BC, Canada.
Y
Y
Mivelaz
K I
KI
Lim
C
C
Templeton
A I
AI
Campbell
J E
JE
Potts
G G S
GG
Sandor
D001955:British Columbia / Q000453:epidemiology; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D011247:Pregnancy; D011379:Prognosis; D011664:Pulmonary Valve / Q000002:abnormalities*; D012189:Retrospective Studies; D015996:Survival Rate; D013771:Tetralogy of Fallot / Q000000981:diagnostic imaging* / Q000453:epidemiology; D016216:Ultrasonography, Prenatal