| Abstrakt: |
Background: Tetralogy of Fallot (ToF) is characterized by the following four features: a nonrestrictive VSD; overriding aorta (but <50%); infundibular, valvular, supravalvular RVOTO and/or branch PA stenosis; and consequent RV hypertrophy (RVH). It is the most common cyanotic cogenital heart defect (CHD). Most of the patients will not reach into adulthood without surgery depending on the degree of RVOTO. So most of adult ToF patients had history of total correction surgery. Major consequences of adult operated ToF patients are pulmonary regurgitation (PR), residual RVOTO, residual VSD, aortic complication and RV and LV dysfunction. Purpose: We aimed to describe demographic, clinical, echocardiographic and CMR characteristics of adult ToF patients. Methods: Adult mostly operated ToF patients are followed at ACHD outpatient of our Universiy Institute of Cardiology were analyzed. Results: There was 91 adult ToF patients (86 operated, 5 non-operated) and almost half of them was male (49.5% vs 50.5%). Seventeen of 46 women (18.7%) had a history of delivery. The mean age was 36.3 ± 9.9 (IQR: 19-71 years). The functional capacity was I, II, and III in 64.8%, 28.6% and 6.6%, respectively. On ECG, the mean QRS duration was 140.6 ± 26.5 msec. While most of patients (93.4%) was in sinus rhythm, there was 4 patients with AF/Aflutter and 2 patients with pace rhythm. On Holter monitoring, 7 patients had NSVT, 12 patients had SVT. On echocardiography, the mean LVEF was 57.8 ± 6.9 %, the mean RV diameter on parasternal long axis view was 31.8 ± 7.2 mm, and the mean TAPSE was 18.1 ± 3.0 mm. Patient with moderate-severe PR consisted 40.7% of whole study population. The mean PA and RVOT diameter on echocardiography were 30.6 ± 5.2 and 31.7 ± 9.6 mm. Table 1 is showing EF, RV and LV volumes and PR regurgitation volumes on CMR. Eighteen patients had fibrosis on CMR especially in RVOT. Conclusion: Here we present demographics, clinical, ECG, echocardiographic and CMR characteristics of adult mostly operated ToF patients. Severe PR is one of the major concerns which necessitates reintervention. Moderate to severe PR was found 40% in our study population. CMR is the gold standard imaging modality in these patient population to evaluate of PR severity and RV volumes which determines prognosis and re-intervention. RV fibrosis on CMR also should be investigated as fibrosis is a negative predictor of survival. [ABSTRACT FROM AUTHOR] |
