Surgically repaired tetralogy of Fallot in the 7th decade: a late presentation of severe pulmonic regurgitation
Abstract Background Surgically repaired tetralogy of Fallot (TOF) is a congenital heart disease with a cumulative survival rate of 72% in the 4th decade of life in longitudinal single-cohort studies. Debate surrounds conservative versus surgical management in adults with TOF once pulmonary regurgita...
| Main Authors: | , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
SpringerOpen
2024-04-01
|
| Series: | The Egyptian Heart Journal |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s43044-024-00477-3 |
| _version_ | 1797199356965683200 |
|---|---|
| author | Kyle Varkoly Akarsh Parekh Melissa Ianitelli Mostafa Hamada Alexandra Lucas Thomas Forbes |
| author_facet | Kyle Varkoly Akarsh Parekh Melissa Ianitelli Mostafa Hamada Alexandra Lucas Thomas Forbes |
| author_sort | Kyle Varkoly |
| collection | DOAJ |
| description | Abstract Background Surgically repaired tetralogy of Fallot (TOF) is a congenital heart disease with a cumulative survival rate of 72% in the 4th decade of life in longitudinal single-cohort studies. Debate surrounds conservative versus surgical management in adults with TOF once pulmonary regurgitation occurs. Case presentation A 73-year-old male with surgically corrected TOF presented with heart failure symptoms. He underwent ToF repair with a classic right Blalock–Taussig shunt at 2 years of age with transannular patching at 18 years of age. Echocardiography revealed elevated right ventricular systolic pressures, severe right ventricular dilatation, and pulmonary regurgitation. Our patient’s new-onset right-sided heart failure was managed medically with diuresis. He received a new pulmonic valve via percutaneous approach on a later planned hospitalization with resolution of symptoms and improved tricuspid regurgitation. Conclusion It is a class I recommendation for pulmonic valve intervention once greater than moderate PR occurs; however, medical optimization should take place first. Following adequate RV load optimization, our patient underwent successful transcatheter pulmonic valve implantation with resolution of symptoms and cessation of diuretic. |
| first_indexed | 2024-04-24T07:14:28Z |
| format | Article |
| id | doaj.art-c47eb6e6bf2941efa26386510001f0e0 |
| institution | Directory Open Access Journal |
| issn | 2090-911X |
| language | English |
| last_indexed | 2024-04-24T07:14:28Z |
| publishDate | 2024-04-01 |
| publisher | SpringerOpen |
| record_format | Article |
| series | The Egyptian Heart Journal |
| spelling | doaj.art-c47eb6e6bf2941efa26386510001f0e02024-04-21T11:22:44ZengSpringerOpenThe Egyptian Heart Journal2090-911X2024-04-017611510.1186/s43044-024-00477-3Surgically repaired tetralogy of Fallot in the 7th decade: a late presentation of severe pulmonic regurgitationKyle Varkoly0Akarsh Parekh1Melissa Ianitelli2Mostafa Hamada3Alexandra Lucas4Thomas Forbes5Department of Internal Medicine, McLaren Macomb Hospital- Michigan State University College of Human MedicineDepartment of Cardiovascular Medicine, McLaren Macomb HospitalDepartment of Cardiovascular Medicine, McLaren Macomb HospitalCollege of Medicine, Kansas City UniversityDepartment of Cardiovascular Medicine, McLaren Macomb HospitalChildren’s Hospital of Michigan, Detroit Medical CenterAbstract Background Surgically repaired tetralogy of Fallot (TOF) is a congenital heart disease with a cumulative survival rate of 72% in the 4th decade of life in longitudinal single-cohort studies. Debate surrounds conservative versus surgical management in adults with TOF once pulmonary regurgitation occurs. Case presentation A 73-year-old male with surgically corrected TOF presented with heart failure symptoms. He underwent ToF repair with a classic right Blalock–Taussig shunt at 2 years of age with transannular patching at 18 years of age. Echocardiography revealed elevated right ventricular systolic pressures, severe right ventricular dilatation, and pulmonary regurgitation. Our patient’s new-onset right-sided heart failure was managed medically with diuresis. He received a new pulmonic valve via percutaneous approach on a later planned hospitalization with resolution of symptoms and improved tricuspid regurgitation. Conclusion It is a class I recommendation for pulmonic valve intervention once greater than moderate PR occurs; however, medical optimization should take place first. Following adequate RV load optimization, our patient underwent successful transcatheter pulmonic valve implantation with resolution of symptoms and cessation of diuretic.https://doi.org/10.1186/s43044-024-00477-3Tetralogy of FallotSurgical repairSeventh decadeAdult congenital heart diseasePulmonic regurgitationHeart failure |
| spellingShingle | Kyle Varkoly Akarsh Parekh Melissa Ianitelli Mostafa Hamada Alexandra Lucas Thomas Forbes Surgically repaired tetralogy of Fallot in the 7th decade: a late presentation of severe pulmonic regurgitation The Egyptian Heart Journal Tetralogy of Fallot Surgical repair Seventh decade Adult congenital heart disease Pulmonic regurgitation Heart failure |
| title | Surgically repaired tetralogy of Fallot in the 7th decade: a late presentation of severe pulmonic regurgitation |
| title_full | Surgically repaired tetralogy of Fallot in the 7th decade: a late presentation of severe pulmonic regurgitation |
| title_fullStr | Surgically repaired tetralogy of Fallot in the 7th decade: a late presentation of severe pulmonic regurgitation |
| title_full_unstemmed | Surgically repaired tetralogy of Fallot in the 7th decade: a late presentation of severe pulmonic regurgitation |
| title_short | Surgically repaired tetralogy of Fallot in the 7th decade: a late presentation of severe pulmonic regurgitation |
| title_sort | surgically repaired tetralogy of fallot in the 7th decade a late presentation of severe pulmonic regurgitation |
| topic | Tetralogy of Fallot Surgical repair Seventh decade Adult congenital heart disease Pulmonic regurgitation Heart failure |
| url | https://doi.org/10.1186/s43044-024-00477-3 |
| work_keys_str_mv | AT kylevarkoly surgicallyrepairedtetralogyoffallotinthe7thdecadealatepresentationofseverepulmonicregurgitation AT akarshparekh surgicallyrepairedtetralogyoffallotinthe7thdecadealatepresentationofseverepulmonicregurgitation AT melissaianitelli surgicallyrepairedtetralogyoffallotinthe7thdecadealatepresentationofseverepulmonicregurgitation AT mostafahamada surgicallyrepairedtetralogyoffallotinthe7thdecadealatepresentationofseverepulmonicregurgitation AT alexandralucas surgicallyrepairedtetralogyoffallotinthe7thdecadealatepresentationofseverepulmonicregurgitation AT thomasforbes surgicallyrepairedtetralogyoffallotinthe7thdecadealatepresentationofseverepulmonicregurgitation |