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Hot Topics in Tetralogy of Fallot

Journal of the American College of Cardiology, 2013-12, Vol.62 (23), p.2155-2166 [Tạp chí có phản biện]

American College of Cardiology Foundation ;2013 American College of Cardiology Foundation ;2015 INIST-CNRS ;Copyright © 2013 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved. ;Copyright Elsevier Limited Dec 10, 2013 ;ISSN: 0735-1097 ;EISSN: 1558-3597 ;DOI: 10.1016/j.jacc.2013.07.100 ;PMID: 24076489 ;CODEN: JACCDI

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Hot Topics in Tetralogy of Fallot
Tác giả: Villafañe, Juan, MD ; Feinstein, Jeffrey A., MD ; Jenkins, Kathy J., MD, MPH ; Vincent, Robert N., MD, CM ; Walsh, Edward P., MD ; Dubin, Anne M., MD ; Geva, Tal, MD ; Towbin, Jeffrey A., MD ; Cohen, Meryl S., MD ; Fraser, Charles, MD ; Dearani, Joseph, MD ; Rosenthal, David, MD ; Kaufman, Beth, MD ; Graham, Thomas P., MD
Chủ đề: arrhythmias ; Biological and medical sciences ; Cardiac arrhythmia ; Cardiac Catheterization ; Cardiac Surgical Procedures - methods ; Cardiology ; Cardiology. Vascular system ; Cardiovascular ; Catheters, Indwelling ; Chromosomes ; Congenital heart diseases. Malformations of the aorta, pulmonary vessels and vena cava ; Death, Sudden, Cardiac - epidemiology ; Death, Sudden, Cardiac - etiology ; Defibrillators, Implantable ; Echocardiography ; Heart ; Heart attacks ; Heart Failure - etiology ; Heart Failure - physiopathology ; Heart Failure - therapy ; Heart Valve Prosthesis Implantation ; Humans ; imaging ; Infant, Newborn ; Internal Medicine ; Magnetic Resonance Imaging ; Medical sciences ; Mortality ; Mutation ; Palliative Care - methods ; pulmonary regurgitation ; Pulmonary Valve Insufficiency - etiology ; Pulmonary Valve Insufficiency - physiopathology ; Pulmonary Valve Insufficiency - surgery ; pulmonary valve replacement ; Reoperation ; sudden cardiac death ; Tachycardia, Atrioventricular Nodal Reentry - etiology ; Tachycardia, Atrioventricular Nodal Reentry - mortality ; Tachycardia, Ventricular - etiology ; Tachycardia, Ventricular - mortality ; tetralogy of Fallot ; Tetralogy of Fallot - complications ; Tetralogy of Fallot - diagnosis ; Tetralogy of Fallot - genetics ; Tetralogy of Fallot - pathology ; Tetralogy of Fallot - physiopathology ; Tetralogy of Fallot - surgery ; Tetralogy of Fallot - therapy ; Ventricular Dysfunction, Left - complications ; Ventricular Dysfunction, Left - etiology ; ventricular function and heart failure
Là 1 phần của: Journal of the American College of Cardiology, 2013-12, Vol.62 (23), p.2155-2166
Mô tả: Tetralogy of Fallot (TOF) is the most common cyanotic congenital heart defect. We explore “hot topics” to highlight areas of emerging science for clinicians and scientists in moving toward a better understanding of the long-term management of patients with repaired TOF. From a genetic perspective, the etiology of TOF is multifactorial, with a familial recurrence risk of 3%. Cardiac magnetic resonance is the gold standard assessment tool based on its superior imaging of the right ventricular (RV) outflow tract, pulmonary arteries, aorta, and aortopulmonary collaterals, and on its ability to quantify biventricular size and function, pulmonary regurgitation (PR), and myocardial viability. Atrial re-entrant tachycardia will develop in more than 30% of patients, and high-grade ventricular arrhythmias will be seen in about 10% of patients. The overall incidence of sudden cardiac death is estimated at 0.2%/yr. Risk stratification, even with electrophysiologic testing and cardiac magnetic resonance, remains imperfect. Drug therapy has largely been abandoned, and defibrillator placement, despite its high risks for complications and inappropriate discharges, is often recommended for patients at higher risk. Definitive information about optimal surgical strategies for primary repair to preserve RV function, reduce arrhythmia, and optimize functional status is lacking. Post-operative lesions are often amenable to transcatheter intervention. In selected cases, PR may be treated with transcatheter valve insertion. Ongoing surveillance of RV function is a crucial component of clinical assessment. Except for resynchronization with biventricular pacing, no medical therapies have been shown to be effective after RV dysfunction occurs. In patients with significant PR with RV dilation, optimal timing of pulmonary valve replacement remains uncertain, although accepted criteria are emerging.
Nơi xuất bản: New York, NY: Elsevier Inc
Ngôn ngữ: English
Số nhận dạng: ISSN: 0735-1097
EISSN: 1558-3597
DOI: 10.1016/j.jacc.2013.07.100
PMID: 24076489
CODEN: JACCDI
Nguồn: GFMER Free Medical Journals
MEDLINE
Alma/SFX Local Collection

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Hot Topics in Tetralogy of Fallot

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