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Long-Term and Multidisciplinary Treatment of Tetralogy of Fallot in Pediatrics

Kai Wang1, Xinyi Xu1, Ying Guo1

  • 1Department of Cardiology, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.

JACC. Case Reports
|April 19, 2025
PubMed

Insights

This case study highlights the successful use of percutaneous pulmonary valve implantation (PPVI) in an adolescent with tetralogy of Fallot (TOF). PPVI offers a minimally invasive solution for right ventricular outflow tract dysfunction, improving patient outcomes.

Area of Science:

  • Cardiology
  • Pediatric Cardiac Surgery
  • Interventional Cardiology

Background:

  • Tetralogy of Fallot (TOF) repair can lead to long-term right ventricular outflow tract (RVOT) dysfunction.
  • This dysfunction often requires ongoing, multidisciplinary management.
  • Pulmonary artery stenosis and regurgitation are common complications post-TOF repair.

Observation:

  • A patient with TOF, surgically repaired in infancy, developed pulmonary artery stenosis and regurgitation.
  • The patient underwent successful pulmonary stent placement at age 5.
  • Percutaneous pulmonary valve implantation (PPVI) was successfully performed at age 13.

Findings:

  • PPVI serves as a minimally invasive alternative to surgical pulmonary valve replacement.
  • PPVI demonstrated significant benefits in pediatric patients with RVOT dysfunction.
  • Key advantages include symptom relief and optimized hemodynamic parameters, potentially avoiding reintervention.

Implications:

  • This case illustrates a long-term, multidisciplinary approach for managing pediatric TOF.
  • It emphasizes the feasibility and effectiveness of PPVI in adolescent patients.
  • PPVI represents a valuable therapeutic option for improving RVOT function in TOF survivors.
Abstract

Keywords:
congenital heart diseasepercutaneous pulmonary valve implantationpulmonary stenosisstenttetralogy of Fallot

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