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Risk factors for severe pulmonary regurgitation after repair of tetralogy of Fallot with transannular patch

Published online by Cambridge University Press:  13 November 2020

Putria Rayani Apandi Open the ORCID record for Putria Rayani Apandi [Opens in a new window] ,
Rubiana Sukardi ,
Mulyadi M. Djer ,
Piprim B. Yanuarso  and
Suprayitno Wardoyo
Putria Rayani Apandi
Affiliation:
Department of Child Health, Faculty of Medicine, Universitas Padjadjaran, Dr. Hasan Sadikin Hospital, Bandung, Indonesia
Rubiana Sukardi*
Affiliation:
Integrated Cardiac Service, Dr. Cipto Mangunkusumo Hospital, University of Indonesia, Jakarta, Indonesia
Mulyadi M. Djer
Affiliation:
Departement of Child Health, Faculty of Medicine, University of Indonesia, Dr. Cipto Mangunkusumo Hospital, Jakarta, Indonesia
Piprim B. Yanuarso
Affiliation:
Departement of Child Health, Faculty of Medicine, University of Indonesia, Dr. Cipto Mangunkusumo Hospital, Jakarta, Indonesia
Suprayitno Wardoyo
Affiliation:
Departement of Cardio-Thoracic Surgery, Faculty of Medicine, Universitiy of Indonesia, Dr. Cipto Mangunkusumo Hospital, Jakarta, Indonesia
*
Author for correspondence: Rubiana Sukardi, Integrated Cardiac Service, Dr. Cipto Mangunkusumo Hospital, University of Indonesia, Jakarta, Indonesia. E-mail: rubiana_sukardi@yahoo.com
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Abstract

Background:

Severe pulmonary regurgitation may result in right ventricular volume overload and decreased right ventricular function. Severe pulmonary regurgitation can be predicted prior to repair of tetralogy of Fallot. The aim of this study was to determine the risk factors for severe pulmonary regurgitation in repaired tetralogy of Fallot with transannular patch.

Methods:

This was a cross-sectional study in 43 patients with repaired tetralogy of Fallot using transannular patch. This study was carried out in Dr. Cipto Mangunkusumo hospital during 2015 to 2018. Participants were followed up for routine examination using echocardiography. We used bivariate and multivariate logistic regression using STATA 12.1 to identify risk factors for severe pulmonary regurgitation in this population.

Results:

A total of 43 patients composed of 22 boys and 21 girls with repaired tetralogy of Fallot using transannular patch were enrolled in the study. Median age of participants was 6 years at admission (2.1–18.5 years) and 3.4 years (1–17 years) at repair. Median length of follow-up was 2.1(1–4.3) years. Risk factors associated with severe pulmonary regurgitation after tetralogy of Fallot repair were McGoon ratio > 1.8 (odds ratio = 6.9; 95% confidence interval = 1.6–30) and follow-up duration >1.9 years (odds ratio = 3.6; 95% confidence interval = 0.9–15.2).

Conclusion:

McGoon ratio > 1.8 and follow-up duration > 1.9 years are associated with severe pulmonary regurgitation after tetralogy of Fallot repair.

Keywords

Tetralogy of Fallottransannular patchsevere pulmonary regurgitation
Type
Original Article
Information
Cardiology in the Young , Volume 30 , Issue 12 , December 2020 , pp. 1917 - 1922
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Copyright
© The Author(s), 2020. Published by Cambridge University Press

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References

Linde, DV, Konings, EEM, Slager, MA, Witsenburg, M, Helbing, WA, Takkenberg, JJM. Birth Prevalence of congenital heart disease worldwide. J Am Coll Cardiol 2011; 58: 2241–2247.CrossRefGoogle ScholarPubMed
Tornell, MG, Lopez, AR, Gonzales, AR, Cerdan, AB, Ojeda, AG, Orozco, CF. Treatment of Fallot tetralogy with a transannular patch. Six year follow up. Cir Cir 2015; 83: 447–554.Google Scholar
Jang, WS, Cho, JY, Lee, JU, Lee, Y. Surgical results of monocusp implantation with transannular patch angioplasty in tetralogy of Fallot repair. Korean J Thorac Cardiovasc Surg 2016; 49: 344–349.CrossRefGoogle ScholarPubMed
Sasson, L, Houri, S, Sternfield, AR, Cohen, I, Lenczner, O. Right ventricular outflow tract strategies for repair of tetralogy of Fallot: effect of monocusp valve reconstruction. Eur J Cardiothorac Surg 2013; 43: 743–751.CrossRefGoogle ScholarPubMed
Pande, S, Sharma, JK, Siddarths, CR, et al. Fresh autologous pericardium to reconstruct the pulmonary valve at the annulus. Heart Inst J 2016; 43: 207–213.CrossRefGoogle Scholar
Khan, AI, Hassan, KA, Salam, A, Azad, QA, Siddiqua, SS, Islam, Z. Total correction of tetralogy of Fallot: effect of transannular patch on early outcome. Cardiovasc J 2018; 10: 194–200.CrossRefGoogle Scholar
Ylitalo, P, Nieminen, H, Pitkanen, OM, Jokinen, E, Sairanen, H. Need of transannular patch in tetralogy of Fallot surgery carries a higher risk of reoperation but has no impact on late survival: results of Fallot repair in Finland. Eur J Cardiothorac Surg 2015; 48: 91–97.CrossRefGoogle ScholarPubMed
Geva, T. Repaired tetralogy of fallot: the roles of cardiovascular magnetic resonance in evaluating pathophysiology and for pulmonary valve replacement decision support. J Cardiovasc Mag Reson 2011; 13: 1–24.Google ScholarPubMed
Gao, Y, Yang, ZG, Shi, K, Diao, KY, Xu, HY, Guo, YK. Computed tomography for evaluating right ventricle and pulmonary artery in pediatric tetralogy of Fallot: correlation with post-operative pulmonary regurgitation. Sci Rep 2018; 8: 1–7.Google ScholarPubMed
Johnson, RJ, Haworth, SG. Pulmonary vascular and alveolar development in tetralogy of Fallot: a recommendation for early correction. Thorax 1982; 37: 893–901.CrossRefGoogle ScholarPubMed
Rosa, LM, Wei, Y, Kutty, S, Rychik, J, Fogel, M, Goldmuntz, E. Quantifying pulmonary regurgitation and right ventricular function in surgically repaired tetralogy of Fallot. A comparative analysis of echocardiography and magnetic resonance imaging. Cir Cardiovasc Imaging 2012; 5: 637–643.CrossRefGoogle Scholar
Lancelotti, P, Tribouiloy, C, Hagendorff, A, et al. Recommendations for the echocardiographic assessment of native valvular regurgitation: an executive summary from the European association of cardiovascular imaging. Eur Heart J Cardiovasc Imaging 2013; 14: 611–644.CrossRefGoogle Scholar
Bacha, EA, Scheule, AM, Zurakowski, D, et al. Long-term result after early primary repair of tetralogy of Fallot. J thorac Cardiovasc Surg 2001; 122: 154–161.CrossRefGoogle Scholar
Tanasan, A, Zanzani, KS, Kocharian, A, Kiani, A, Navabi, MA. Right ventricular myocardial tissue velocities, myocardial performance index, and tricuspid annular plane systolic excursion in totally corrected tetralogy of Fallot patients. J Teh Univ Heart Ctr 2012; 7: 160–163.Google ScholarPubMed
Murni, IK, Djer, MM, Yanuarso, PB, et al. Outcome of pediatric cardiac surgery and predictors of major complication in a developing country. Ann Pediatr Cardiol 2019; 12: 38–44.CrossRefGoogle ScholarPubMed
Cunningham, MEA, Donofrio, MT, Peer, SM, Zurakowski, D, Jonas, RA, Sinha, P. Optimal timing for elective early primary repair of tetralogy of Fallot: analysis of intermediate term outcomes. Ann Thorac Surg 2017; 107: 845–852.CrossRefGoogle Scholar
Memon, MKY, Akhtar, S, Mohsin, M, Ahmad, W, Arshad, A, Ahmed, MA. Short and midterm outcome of Fallot’s tetralogy repair in infancy: a single experience in a developing country. J ayub Med Coll Abbotabad 2019; 31: 383–387.Google Scholar
Lutijen, LWG, Van den Bosch, E, Duppen, N, et al. Long-term outcomes of transatrial-transpulmonary repair of tetralogy of Fallot. Eur J Cardiothorac Surg 2015; 47: 527–534.Google Scholar
Chen, BB, Chen, SJ, Wu, MH, Li, YW, Lue, HC. EBCT-McGoon ratio a reliable and useful method to predict pulmonary artery blood flow non-invasively. Chin J Radiol 2007; 32: 1–8.Google Scholar
Killner, PJ, Balossino, R, Dubini, G, et al. Pulmonary regurgitation: the effect of varying pulmonary artery compliance, and of increased resistance proximal or distal to the compliance. Int J Cardiol 2009; 133: 157–166.CrossRefGoogle Scholar
Van der Ven, JPG, Van den Bosch, E, Bogers, AJCC, Helbing, WA. Current outcomes and treatment of tetralogy of Fallot (Version 1;peer review:2 approved) F1000Research.2019,8(F1000 Faculty Rev):1530.CrossRefGoogle Scholar
Redington, AN. Physiology of right ventricular failure. Semin Thorac Cardiovasc Surg Pediatr Card Annu 2006; 9: 3–10.CrossRefGoogle Scholar
Pilla, CB, Pereira, CA, Fin, AV, et al. Health related quality of life and right ventricular function in the midterm follow-up assessment after tetralogy of Fallot repair. Pediatr Cardiol 2008; 29: 409–415.CrossRefGoogle ScholarPubMed
Shehata, EMA, El Nagar, ESM, Shara, MED, Abu-Farag, IM. Echocardiography assessment of right ventricular functions in children after surgical repair of tetralogy of Fallot. Sci J Al-Azhar Med Fac Girls 2019; 3: 283–290.CrossRefGoogle Scholar
Egbe, AC, Mittnacht, AJ, Nguyen, K, Joshi, U. Risk factors for morbidity in infants undergoing tetralogy of Fallot repair. Ann Pediatr Cardiol 2014; 7: 13–18.CrossRefGoogle ScholarPubMed