David Aurigemma, John W. Moore, Gabrielle Vaughn, Nasser Moiduddin, Howaida G. El-Said

Congenital Heart Disease, Vol.13, No.2, pp. 226-231, 2018, DOI:10.1111/chd.12552

Abstract Background: Right ventricular outflow tract (RVOT) stents have been used as palliation in patients with severe tetralogy of Fallot (TOF). Radiofrequency perforation of the RVOT has also been described in patients with pulmonary atresia (PA)/ventricular septal defect (VSD). However, RVOT stenting in conjunction with radiofrequency perforation as a means for establishing reliable pulmonary blood flow in patients with PA/VSD has not previously been reported.
Objectives: Our aim is to report our experience with using perforation of plate-like pulmonary valve atresia combined with stenting of RVOT as an alternative and equally efficacious intervention for infants with PA/VSD, as compared to a… More >

Mary K. Olive¹, Charles D. Fraser², Shelby Kutty³, Emmett D. McKenzie⁴, James M. Hammel⁵, Rajesh Krishnamurthy⁶, Nicolas A. Dodd⁷, Shiraz A. Maskatia⁸

Congenital Heart Disease, Vol.14, No.6, pp. 1149-1156, 2019, DOI:10.1111/chd.12863

Abstract Introduction: The right ventricular infundibular sparing approach (RVIS) to the repair of tetralogy of Fallot (TOF) avoids a full-thickness ventricular incision, typically utilized in the transinfundibular (TI) method.
Methods: We performed a retrospective, age-matched cohort study of patients who underwent RVIS at Texas Children’s Hospital or TI at Children’s Hospital Medical Center in Nebraska and subsequently underwent cardiac magnetic resonance imaging (CMR). We compared right ventricular end-diastolic and systolic volumes indexed to body surface area (RVEDVi and RVESVi) and right ventricular ejection fraction (RVEF) as primary endpoints. Secondary endpoints were indexed left ventricular diastolic and systolic volume (LVEDVi and LVESVi),… More >

Alexander C. Egbe, Sorin V. Pislaru, Srikanth Kothapalli, Raja Jadav, Muhammad Masood, Mounika Angirekula, Patricia A. Pellikka

Congenital Heart Disease, Vol.14, No.5, pp. 700-705, 2019, DOI:10.1111/chd.12783

Abstract Background: Quantitative assessment of right ventricular (RV) systolic function by echocardiography is challenging in patients with congenital heart disease because of the complex geometry of the RV and the iatrogenic structural abnormalities resulting from prior cardiac surgeries. The purpose of this study was to determine the correla‐ tion between echocardiographic indices of RV systolic function and cardiac magnetic resonance imaging (CMRI) derived RV ejection fraction (RVEF) in adults with repaired tetralogy of Fallot (TOF).
Methods: Quantitative assessment of RV function was performed with RV tissue Doppler systolic velocity (RV s'), tricuspid annular plane systolic excursion (TAPSE), and fractional area change… More >

Vidhya Annavajjhala¹, Rajesh Punn¹, Theresa A. Tacy¹, Frank L. Hanley², Doff B. McElhinney²

Congenital Heart Disease, Vol.14, No.5, pp. 691-699, 2019, DOI:10.1111/chd.12772

Abstract Background: Little is known about the early time course of biventricular function and mechanics after tetralogy of Fallot (TOF) repair. We sought to evaluate and describe the evolution of the right ventricle (RV) after TOF repair in young infants and children using conventional echocardiographic parameters and global longitudinal strain (GLS).
Methods: A retrospective review was performed of all patients with TOF and pulmo‐ nary stenosis who underwent repair from January 2002 to September 2015 and had at least 3 serial postsurgical echocardiograms spanning from infancy to early child‐ hood (<8 years). Student’s t test was performed to compare patients who… More >

Alexander C. Egbe, Sindhura Ananthaneni, Raja Jadav, Srikanth Kothapalli, Charanjit S. Rihal, Muhammad Masood, Mounika Angirekula, Maria Najam, Numra Bajwa, Karim Tarek, Jessey Matthew, Heidi M. Connolly

Congenital Heart Disease, Vol.14, No.3, pp. 491-497, 2019, DOI:10.1111/chd.12782

Abstract Background: There are limited data about outcomes of coronary artery disease (CAD) in adults with repaired tetralogy of Fallot (TOF). The purpose of this study was to describe the prevalence and treatment of CAD in adults with TOF, and the impact of CAD on long‐term survival.
Methods: Retrospective review of MACHD database for adults with repaired TOF who underwent aortic root/selective coronary angiogram, 1990‐2017. Patients were categorized into three groups: (1) No CAD defined as normal coronary angiogram; (2) Mild CAD defined as ≤50% stenosis in all vessels; and, (3) Significant CAD defined as >50% stenosis in any vessel.
Results:… More >

Richard J. Dobson¹, Ify Mordi², Mark H. Danton¹, Niki L. Walker¹, Hamish A. Walker¹, Nikolaos Tzemos²

Congenital Heart Disease, Vol.12, No.1, pp. 58-66, 2017

Abstract Objective: Myocardial fibrosis has been associated with poorer outcomes in tetralogy of Fallot, however only a handful of studies have assessed its significance in the current era. Our aim was to quantify the amount of late gadolinium enhancement in both the LV and RV in a contemporary cohort of adults with surgically repaired tetralogy of Fallot, and assess the relationship with adverse clinical outcomes.
Design: Single centre cohort study
Setting: National tertiary referral center
Patients: One hundred fourteen patients with surgically repaired tetralogy of Fallot with median age 29.5 years (range 17.5-64.2). Prospective follow-up for mean 2.4 years (SD 1.29).
… More >

Caili Li^1,§, Christopher Baird², Jing Yao³, Chun Yang⁴, Liang Wang⁵, Han Yu⁵, Tal Geva⁶, Dalin Tang^5,*,7,§

Molecular & Cellular Biomechanics, Vol.16, Suppl.2, pp. 59-59, 2019, DOI:10.32604/mcb.2019.06872

Abstract Pulmonary valve stenosis (PVS) is one common right ventricular outflow tract obstruction problem in patients with tetralogy of Fallot (TOF). Congenital bicuspid pulmonary valve (BPV) is a condition of valvular stenosis, and the occurrence of congenital BPV is often associated with TOF. Dynamic computational models of normal pulmonary root (PR) with tri-leaflet and PR with BPV in patients with TOF were developed to investigate the effect of geometric structure of BPV on valve stress and strain distributions. The pulmonary root geometry included valvular leaflets, sinuses, interleaflet triangles and annulus. Mechanical properties of pulmonary valve leaflet were obtained from biaxial testing… More >

Han Yu¹, Tal Geva², Rahul H. Rathod², Alexander Tang², Chun Yang³, Zheyang Wu³, Kristen L. Billiar⁴, Xueying Huang⁵, Dalin Tang^1,*,3

Molecular & Cellular Biomechanics, Vol.16, Suppl.2, pp. 56-57, 2019, DOI:10.32604/mcb.2019.07257

Abstract Computational biomechanical models are widely used in cardiovascular research for better understanding of mechanisms governing disease development, quantitative diagnostic strategies and improved surgical designs with better outcome. Patients with repaired tetralogy of Fallot (TOF) account for the majority of cases with late onset right ventricle (RV) failure. The current surgical approach, which includes pulmonary valve replacement/insertion (PVR), has yielded mixed results. An innovative PVR surgical approach was proposed using active contracting bands to help ventricle to contract and improve RV function measured by ejection fraction [1]. Muscle active contraction caused by sarcomere shortening leads to change of zero-load configurations. In… More >

Caili Li¹, Jing Yao², Chun Yang³, Di Xu², Liang Wang⁴, Dalin Tang^4,5,*

Molecular & Cellular Biomechanics, Vol.16, Suppl.1, pp. 77-78, 2019, DOI:10.32604/mcb.2019.05745

Abstract Pulmonary valve stenosis (PVS) is one common post-operative problem in patients with tetralogy of Fallot (TOF) after repair. Congenital bicuspid pulmonary valve (BPV) is a condition of valvular stenosis, and the occurrence of congenital BPV is often associated with TOF. Compared with the biomechanical simulation model of the bicuspid aortic valve, the BPV is often neglected. In this study, we developed a dynamic biomechanical model of a simulated normal pulmonary root (PR) with tri-leaflet and a model of simulated PR with BPV in patients with repaired TOF in order to describe the effect of geometric structure with BPV on the… More >

Han Yu¹, Pedro J. del Nido², Tal Geva³, Chun Yang⁴, Zheyang Wu⁴, Rahul H. Rathod³, Xueying Huang⁵, Kristen L. Billiar⁶, Dalin Tang^1,4,*

Molecular & Cellular Biomechanics, Vol.16, Suppl.1, pp. 73-74, 2019, DOI:10.32604/mcb.2019.05837

Abstract Ventricle mechanical stress and strain calculations play an important role in cardiovascular investigations. Patients with repaired tetralogy of Fallot (TOF) account for the majority of cases with late onset right ventricular (RV) failure. The current surgical approach, including pulmonary valve replacement(PVR), has yielded mixed results with some patients recover RV function after pulmonary valve insertion with or without concomitant RV remodeling surgery but some do not[Therrien, Siu and McLaughlin (2000);]. Cardiac magnetic resonance (CMR) data were collected from 6 healthy volunteers and 12 Tetralogy of Fallot (TOF) patients before PVR with consent obtained. 12 patients were divided into two groups… More >