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Long term follow-up results of adult operated ToF patients

Session Poster Session 1

Speaker Umit Yasar Sinan

Congress : Acute Cardiovascular Care 2019

  • Topic : valvular, myocardial, pericardial, pulmonary, congenital heart disease
  • Sub-topic : Pulmonary Circulation, Pulmonary Embolism, Right Heart Failure - Clinical
  • Session type : Poster Session
  • FP Number : P274

Authors : U Y Sinan (Istanbul,TR), O Onder (Istanbul,TR), MS Kucukoglu (Istanbul,TR)


U Y Sinan1 , O Onder1 , MS Kucukoglu1 , 1Istanbul University Cardiology Institute, Department of Cardiology - Istanbul - Turkey ,


Background: Tetralogy of Fallot consists 10% of all congenital cardiac anomalies. We aimed to review the long term clinical and echocardiographical data, presence of arrhythmias, assessment of ventricular function of patients with operated tetralogy of Fallot.
Methods: We retrospectively reviewed the medical records of operated tetralogy of Fallot patients that was followed up at adult congenital heart disease outpatient clinic of our university hospitalal between January 2015 and June 2017.  

Results: The mean age of study populations was 32,7±10,2 years old (range between 14-66 years old). There were 33 women (58.9%) and 23 men (41.1%) (N:56). The total correction operation age was mean 6,3±4.85 years old (range between 6 months and 30 years old). The mean follow up ranges between 9 and 45 years. According to 24 hour ambulatory holter recordings, 8 patients (14.3%) had supra-ventricular tachycardia (SVT), 7 patients (12.5%) had non-sustained ventricular tachycardia (VT). The mean NT-proBNP level was ranged between 17-623 pg/ml. On TTE,  mean TAPSE was 17 ± 2 mm. Mean tricuspid annulus peak S’ velocity was 10,3 ± 2,4 mm. Pulmonary regurgitation was severe in 4 patients (7.1%), moderate in 9 (16.1%) patients and mild in 43 patients (76.8%). There was no statically significant correlation between RVEF and severity of PR. The correlation analysis between RV function (TAPSE, TAPSE and S’) and BNP showed correlation coefficient was 0.11 (p:0.47) between  BNP and FAC; 0.32 (p:0.42) BNP and TAPSE; and 0.01 (p:0.92) BNP and S’. There was only correlation between TAPSE and BNP (r=0,38, p=0,04). There was no difference between patients with normal RV function and with RV dysfunction in the meaning of QRS duration and mean BNP level.

Conclusion: After total correction of ToF, patients should be followed up for progression PR, presence of RV dysfunction, RVOT obstruction and arrhythmias. Re-operation may be necessary within years. BNP is also useful follow up parameters to diagnose RV dysfunction earlier.

Parameter Correlation BNP (pg/ml) QRS (msn)
FAC (%, mean±SD)


P value





TAPSE (mm, mean±SD)


P value





S' (cm/sn, mean±SD)


P value





Correlation between RV systolic function parameters and BNP, QRS duration

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