Risk Factors of Right Ventricular Dysfunction and Adverse Cardiac Events in Patients with Repaired Tetralogy of Fallot

Benedetta Leonardi, Camilla Calvieri, Marco Alfonso Perrone, Arianna Di Rocco, Adriano Carotti, Massimo Caputo, Aurelio Secinaro, Davide Curione, Maria Giulia Gagliardi, Paolo Guccione, Sonia Albanese, Lorenzo Galletti and Fabrizio Drago
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Benedetta Leonardi: Department of Cardiology and Cardiac Surgery, Bambino Gesù Children’s Hospital IRCCS, 00165 Rome, Italy
Camilla Calvieri: Department of Cardiology and Cardiac Surgery, Bambino Gesù Children’s Hospital IRCCS, 00165 Rome, Italy
Marco Alfonso Perrone: Department of Cardiology and Cardiac Surgery, Bambino Gesù Children’s Hospital IRCCS, 00165 Rome, Italy
Arianna Di Rocco: Department of Public Health and Infectious Diseases, Sapienza University of Rome, 00185 Rome, Italy
Adriano Carotti: Department of Cardiology and Cardiac Surgery, Bambino Gesù Children’s Hospital IRCCS, 00165 Rome, Italy
Massimo Caputo: Bristol Medical School, University of Bristol, Bristol BS2 8HW, UK
Aurelio Secinaro: Department of Radiology, Bambino Gesù Children’s Hospital IRCCS, 00165 Rome, Italy
Davide Curione: Department of Radiology, Bambino Gesù Children’s Hospital IRCCS, 00165 Rome, Italy
Maria Giulia Gagliardi: Department of Cardiology and Cardiac Surgery, Bambino Gesù Children’s Hospital IRCCS, 00165 Rome, Italy
Paolo Guccione: Department of Cardiology and Cardiac Surgery, Bambino Gesù Children’s Hospital IRCCS, 00165 Rome, Italy
Sonia Albanese: Department of Cardiology and Cardiac Surgery, Bambino Gesù Children’s Hospital IRCCS, 00165 Rome, Italy
Lorenzo Galletti: Department of Cardiology and Cardiac Surgery, Bambino Gesù Children’s Hospital IRCCS, 00165 Rome, Italy
Fabrizio Drago: Department of Cardiology and Cardiac Surgery, Bambino Gesù Children’s Hospital IRCCS, 00165 Rome, Italy

IJERPH, 2021, vol. 18, issue 19, 1-16

Abstract: Aim: This study evaluates the risk factors associated with right ventricular (RV) dilation and dysfunction leading to pulmonary valve replacement (PVR) or adverse cardiac events in repaired Tetralogy of Fallot (rToF) patients. Methods: Data from all rToF patients who underwent magnetic resonance imaging (MRI) evaluation at our hospital between February 2007 and September 2020 were collected. Results: Three hundred and forty-two patients (60% males, 42% older than 18 years), with a median age of 16 years (IQR 13–24) at the time of MRI, were included. All patients underwent complete repair at a median age of 8 months (IQR 5–16), while palliation was performed in 56 patients (16%). One hundred and forty-four patients (42%) subsequently received pulmonary valve replacement (PVR). At the multivariate analysis, male gender was an independent predictor for significant RV dilation, RV and left ventricular (LV) dysfunction. Transventricular ventricular septal defect (VSD) closure and previous palliation significantly affected LV function and RV size, respectively. Male gender and the transventricular VSD closure were independent predictors for PVR. Conclusions: Male gender and surgical history (palliation, VSD closure approach) significantly affected the long-term outcomes in rToF patients and should be taken into consideration in the follow-up management and in PVR timing in this patient population.

Keywords: Tetralogy of Fallot; cardiac magnetic resonance imaging; right ventricle dysfunction; repaired Tetralogy of Fallot; pulmonary valve (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2021
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