Adults with repaired tetralogy of fallot: Fixed but not cured

Pulmonary regurgitation with progressive RV dysfunction is the most common hemodynamic problem encountered in patients with repaired Tetralogy of Fallot. Evaluation of pulmonary regurgitation and RV function requires a combination of Echocardiography and MRI. Percutaneous pulmonary valve insertion is possible and may become widely available in the near future. It offers the hope of reducing the need for multiple surgical reoperations in these young patients. Ventricular arrhythmias are the most common cause of late sudden death and may reflect underlying hemodynamic problems as well as an arrhythmogenic substrate from the surgical scar site. A QRS duration >180ms appears to be a sensitive predictor of sudden death and sustained ventricular arrhythmias.

Duke Scholars

Author Afshin Farzaneh-Far Medicine, Cardiology