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Title:
Long-term follow-up in adults after tetralogy of Fallot repair
Author:
Subject:
quality of life ; long term follow up ; cardiopulmonary exercise test ; cardiac magnetic resonance ; fallot tetralogy
Abstract:
Tetralogy of Fallot (ToF) is the most common congenital cyanotic heart disease. Thanks to surgical correction, the survival rate of 20-30 years is nearly 90%. Only a few previous studies have described long-term observations of patients after ToF repair. The aim of the study was to describe and analyze long-term follow-up of patients after ToF correction. 143 consecutive adult patients with repaired ToF being in care of the Department of Congenital Defects Jana Pawła II and hospitalized in the Department of Cardiac and Vascular Diseases of the KSS John Paul II in Krakow, were included. The control group consisted of age- and sex-matched healthy volunteers. Patients were referred for electrocardiography, echocardiography, magnetic resonance, cardiopulmonary exercise test and SF-36 quality of life questionnaire. In patients group peak oxygen uptake was markedly lower compared with control subject. Patients after the ToF correction had a lower heart rate. The left ventricular ejection fraction positively correlated with the right ventricular ejection fraction (p = 0.03) and negatively with the right ventricular chamber volumes (p = 0.01) and right ventricle mass (p < 0.001). Peak oxygen consumption positively correlated with physical health domains (p < 0.001). The right ventricle ejection fraction positively correlated with the influence of physical functioning on everyday life ( ; p = 0.04). In the long-term observation, depending on the time from the operation, the values cardiopulmonary exercise testing did not differ significantly. Ejection fraction, mass of both chambers, fraction of pulmonary regurgitation were not significantly different. The ejection fraction and the mass of the ventricles, the indexed volume of pulmonary regurgitation did not correlate with the time of repair. The right ventricle ejection fraction negatively correlated with the duration of QRS (p < 0.001). There was positive correlation between the duration of the QRS complex and the right ventricular end-diastolic volume (p < 0.02), indexed right ventricular end-diastolic volume (p = 0.04), right mass (p < 0.001) and the left (p = 0.04) chamber. Long-term survival and clinical condition after surgical ToF correction is generally good. Adult patients after ToF repair have reduced exercise tolerance. Impaired right ventricular function may be associated with left ventricular dysfunction which suggests right-to-left ventricular interaction. The right ventricle function is associated with the quality of life of patients.
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Level of degree:
Degree discipline:
choroby układu krążenia ; kardiochirurgia