[Cyanotic heart disease. Part 2].

Area of Science:

• Congenital Heart Disease
• Pediatric Cardiology
• Cardiac Surgery

Context:

• Tetralogy of Fallot is the most common cyanotic heart disease with good surgical outcomes.
• Double-outlet right ventricle presents diverse morphologies requiring tailored surgical approaches.
• Late complications after correction of cyanotic heart disease are significant.

Purpose:

• To review current understanding and management of Tetralogy of Fallot and Double-Outlet Right Ventricle.
• To highlight late adverse outcomes following surgical correction.
• To discuss evolving strategies for complex congenital heart defects like tricuspid atresia and single ventricle.

Summary:

• Tetralogy of Fallot correction yields good results, but late issues include pulmonary and aortic valve regurgitation, right heart failure, arrhythmias, and sudden death.
• Double-outlet right ventricle management is morphology-dependent, involving various repair techniques.
• Tricuspid atresia and single ventricle treatments aim for total cavopulmonary connection, with extracardiac approaches potentially reducing arrhythmias compared to intracardiac methods.

Impact:

• Improved understanding of long-term sequelae in cyanotic heart disease.
• Informed surgical decision-making for complex congenital heart defects.
• Guidance on managing late complications and optimizing outcomes in pediatric cardiac surgery.