This preprint is under consideration at Cardiovascular Ultrasound. A preprint is a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Research
The Impact of Native Fallot Anatomy on Future Therapeutic Requirements and Outcomes at Follow-up
Lamia Ait Ali
Istituto di Fisiologia Clinica CNR
Corresponding Author
ORCiD: https://orcid.org/0000-0003-1672-5308
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Background: In patients with repaired Fallot, subsequent surgical or interventional procedures and adverse cardiac events are frequent. We aimed to evaluate the impact of a simple pre-operative anatomic classification based on the size of the pulmonary valve annulus and branches on future therapeutic requirements and outcomes.
Method This is a single-center retrospective analysis of patients operated for Fallot before the age of 2 years, from January 1990. Pre-operative anatomy, surgical and interventional procedures and adverse events were extrapolated from clinical records.
Results: Among the 312 patients, a description of the PV and PAs native anatomy was known in 239 patients (male:147, 61.5%), which were divided in the following 3 groups: group 1 (65 patients) with normal size of both pulmonary valve and pulmonary artery branches; group 2 (108 patients) with pulmonary valve hypoplasia but normal size pulmonary artery branches; group 3 (66 patients) with concomitant hypoplasia of the pulmonary valve and pulmonary artery branches. During the 12.7 years (IQR 6.7-17) follow-up time, 23% of patients required at least one surgical or interventional procedure. At Kaplan-Meier analysis, there was a significant difference in requirement of future surgical or interventional procedures among the 3 groups (p<0,001). At multivariate Cox regression analysis, hypoplasia of pulmonary valve and artery branches was an independent predictor of subsequent procedures (HR:3.1,CI:1.06-9.1, p=0.03).
Conclusion native anatomy in Tetralogy of Fallot patients affects surgical strategy and follow-up. It would be therefore advisable to tailor patient’s counseling and follow-up according to native anatomy, rather than following a standardized protocol.
Keywords
Tetralogy of Fallot, native anatomy, surgical/interventional procedure, follow-up
Figure 1
Figure 2
Figure 3
This is a list of supplementary files associated with this preprint. Click to download.
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Under Review
Version 1
Posted 30 Dec, 2020
No community comments so far
Reviewers invited
Invitations sent on 28 Dec, 2020
Editor assigned
On 26 Dec, 2020
Editor invited
On 26 Dec, 2020
Submission checks complete
On 26 Dec, 2020
First submitted
On 22 Dec, 2020
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
Subject Areas
Cardiac & Cardiovascular Systems
Learn more about our company.
This preprint is under consideration at Cardiovascular Ultrasound. A preprint is a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Research
The Impact of Native Fallot Anatomy on Future Therapeutic Requirements and Outcomes at Follow-up
Lamia Ait Ali
Istituto di Fisiologia Clinica CNR
Corresponding Author
ORCiD: https://orcid.org/0000-0003-1672-5308
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Under Review
Version 1
Posted 30 Dec, 2020
No community comments so far
Reviewers invited
Invitations sent on 28 Dec, 2020
Editor assigned
On 26 Dec, 2020
Editor invited
On 26 Dec, 2020
Submission checks complete
On 26 Dec, 2020
First submitted
On 22 Dec, 2020
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
Subject Areas
Cardiac & Cardiovascular Systems
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Background: In patients with repaired Fallot, subsequent surgical or interventional procedures and adverse cardiac events are frequent. We aimed to evaluate the impact of a simple pre-operative anatomic classification based on the size of the pulmonary valve annulus and branches on future therapeutic requirements and outcomes.
Method This is a single-center retrospective analysis of patients operated for Fallot before the age of 2 years, from January 1990. Pre-operative anatomy, surgical and interventional procedures and adverse events were extrapolated from clinical records.
Results: Among the 312 patients, a description of the PV and PAs native anatomy was known in 239 patients (male:147, 61.5%), which were divided in the following 3 groups: group 1 (65 patients) with normal size of both pulmonary valve and pulmonary artery branches; group 2 (108 patients) with pulmonary valve hypoplasia but normal size pulmonary artery branches; group 3 (66 patients) with concomitant hypoplasia of the pulmonary valve and pulmonary artery branches. During the 12.7 years (IQR 6.7-17) follow-up time, 23% of patients required at least one surgical or interventional procedure. At Kaplan-Meier analysis, there was a significant difference in requirement of future surgical or interventional procedures among the 3 groups (p<0,001). At multivariate Cox regression analysis, hypoplasia of pulmonary valve and artery branches was an independent predictor of subsequent procedures (HR:3.1,CI:1.06-9.1, p=0.03).
Conclusion native anatomy in Tetralogy of Fallot patients affects surgical strategy and follow-up. It would be therefore advisable to tailor patient’s counseling and follow-up according to native anatomy, rather than following a standardized protocol.
Figure 1
Figure 2
Figure 3