scholarly journals Phenylephrine increases pulmonary blood flow in children with tetralogy of Fallot

2003 ◽  
Vol 50 (9) ◽  
pp. 926-929 ◽  
Author(s):  
Katsuya Tanaka ◽  
Hiroshi Kitahata ◽  
Shinji Kawahito ◽  
Junpei Nozaki ◽  
Yoshinobu Tomiyama ◽  
...  
Keyword(s):  
Blood Flow ◽  
Tetralogy Of Fallot ◽  
Pulmonary Blood Flow

scholarly journals Is there any need for a shunt in the treatment of tetralogy of Fallot with one source of pulmonary blood flow?†

2013 ◽  
Vol 44 (4) ◽  
pp. 648-654 ◽  
Author(s):  
Claudia Arenz ◽  
Alke Laumeier ◽  
Stefanie Lütter ◽  
Hedwig Christine Blaschczok ◽  
Nicodème Sinzobahamvya ◽  
...  
Keyword(s):  
Blood Flow ◽  
Tetralogy Of Fallot ◽  
Pulmonary Blood Flow

Systemic hypertension in an infant with unrepaired tetralogy of Fallot: case report

2012 ◽  
Vol 23 (5) ◽  
pp. 746-748
Author(s):  
Michael Khoury ◽  
Michael Kallile ◽  
Joseph May ◽  
Rajesh Punn
Keyword(s):  
Blood Flow ◽  
Case Report ◽  
Tetralogy Of Fallot ◽  
Pulmonary Blood Flow ◽  
Pulmonary Valve ◽  
Right Ventricular Outflow Tract ◽  
Ventricular Outflow Tract ◽  
Flow Dynamics ◽  
Systemic Hypertension ◽  
Pulmonary Valve Stenosis

AbstractPatients with severe right ventricular outflow tract obstruction in tetralogy of Fallot typically have right-to-left shunting, resulting in low pulmonary blood flow and cyanosis. Here we present the case of an infant with tetralogy of Fallot and severe pulmonary valve stenosis, complicated by systemic hypertension, the presence of which altered flow dynamics and possibly prevented cyanosis.

Echocardiographic Assessment of the Alterations in Pulmonary Blood Flow Associated with Ketamine and Etomidate Administration in Children with Tetralogy of Fallot

2015 ◽  
Vol 33 (2) ◽  
pp. 307-313 ◽  
Author(s):  
Ajay K. Jha ◽  
Parag Gharde ◽  
Sandeep Chauhan ◽  
Usha Kiran ◽  
Poonam Malhotra Kapoor
Keyword(s):  
Blood Flow ◽  
Tetralogy Of Fallot ◽  
Pulmonary Blood Flow ◽  
Echocardiographic Assessment

Tetralogy of Fallot With Pulmonary Atresia: Anatomy, Physiology, Imaging, and Perioperative Management

2020 ◽  
pp. 108925322092048
Author(s):  
Madhusudan Ganigara ◽  
Eyal Sagiv ◽  
Sujatha Buddhe ◽  
Aarti Bhat ◽  
Sathish M. Chikkabyrappa
Keyword(s):  
Blood Flow ◽  
Tetralogy Of Fallot ◽  
Pulmonary Blood Flow ◽  
Ductus Arteriosus ◽  
Pulmonary Arteries ◽  
Pulmonary Atresia ◽  
Sole Source ◽  
Aortic Insufficiency ◽  
Collateral Arteries ◽  
Antegrade Flow

Tetralogy of Fallot (ToF) with pulmonary atresia (ToF-PA) is a complex congenital heart defect at the extreme end of the spectrum of ToF, with no antegrade flow into the pulmonary arteries. Patients differ with regard to the sources of pulmonary blood flow. In the milder spectrum of disease, there are confluent branch pulmonary arteries fed by ductus arteriosus. In more severe cases, however, the ductus arteriosus is absent, and the sole source of pulmonary blood flow is via major aortopulmonary collateral arteries (MAPCAs). The variability in the origin, size, number, and clinical course of these MAPCAs adds to the complexity of these patients. Currently, the goal of management is to establish pulmonary blood flow from the right ventricle (RV) with RV pressures that are ideally less than half of the systemic pressure to allow for closure of the ventricular septal defect. In the long term, patients with ToF-PA are at higher risk for reinterventions to address pulmonary arterial or RV-pulmonary artery conduit stenosis, progressive aortic root dilation and aortic insufficiency, and late mortality than those with less severe forms of ToF.

scholarly journals Alteration of pulmonary blood flow in tetralogy of Fallot: pre- and postoperative study with macroaggregates of 99mTc-labeled human serum albumin.

1992 ◽  
Vol 56 (10) ◽  
pp. 992-997 ◽  
Author(s):  
KAZUHIRO HASHIMOTO ◽  
YUZURU NAKAMURA ◽  
MICHIHIKO MATSUI ◽  
HIROMI KUROSAWA ◽  
TATSUTA ARAI
Keyword(s):  
Blood Flow ◽  
Human Serum Albumin ◽  
Serum Albumin ◽  
Human Serum ◽  
Tetralogy Of Fallot ◽  
Pulmonary Blood Flow ◽  
Postoperative Study

Breathing training improves exercise capacity in patients with tetralogy of Fallot: a randomised trial

Heart ◽  
2021 ◽  
pp. heartjnl-2020-318574
Author(s):  
Julia Hock ◽  
Julia Remmele ◽  
Renate Oberhoffer ◽  
Peter Ewert ◽  
Alfred Hager
Keyword(s):  
Blood Flow ◽  
Tetralogy Of Fallot ◽  
Exercise Capacity ◽  
Pulmonary Blood Flow ◽  
Randomised Trial ◽  
Cardiopulmonary Exercise Testing ◽  
Young Patients ◽  
Control Group ◽  
Lung Volumes ◽  
Breathing Training

ObjectivePatients with tetralogy of Fallot (ToF) have limited pulmonary blood flow before corrective surgery and ongoing dysfunction of the pulmonary valve and right ventricle throughout life leading to lower exercise capacity and lung volumes in many patients. Inhalation training can increase lung volumes, improve pulmonary blood flow and consequently exercise capacity. This study tests whether home-based daily breathing training improves exercise capacity and lung volumes.MethodsFrom February 2017 to November 2018, 60 patients (14.7±4.8 years, 39% female) underwent spirometry (forced vital capacity (FVC); forced expiratory volume in 1 s (FEV1)), cardiopulmonary exercise testing (peak oxygen uptake (peak V˙O2)) and breathing excursion measurement. They were randomised into immediate breathing exercise or control group (CG) and re-examined after 6 months. The CG started their training afterwards and were re-examined after further 6 months. Patients trained with an inspiratory volume-oriented breathing device and were encouraged to exercise daily. The primary endpoint of this study was the change in peak V˙O2. Results are expressed as mean±SEM (multiple imputations).ResultsIn the first 6 months (intention to treat analysis), the training group showed a more favourable change in peak V˙O2 (Δ0.5±0.6 vs −2.3±0.9 mL/min/kg, p=0.011), FVC (Δ0.18±0.03 vs 0.08±0.03 L, p=0.036) and FEV1 (Δ0.14±0.03 vs −0.00±0.04 L, p=0.007). Including the delayed training data from the CG (n=54), this change in peak V˙O2 correlated with self-reported weekly training days (r=0.282, p=0.039).ConclusionsDaily inspiratory volume-oriented breathing training increases dynamic lung volumes and slows down deconditioning in peak V˙O2 in young patients with repaired ToF.

Perioperative and Anesthetic Considerations in Tetralogy of Fallot With Pulmonary Atresia

2021 ◽  
Vol 25 (3) ◽  
pp. 218-228 ◽  
Author(s):  
Casey A. Quinlan ◽  
Gregory J. Latham ◽  
Denise Joffe ◽  
Faith J. Ross
Keyword(s):  
Blood Flow ◽  
Tetralogy Of Fallot ◽  
Pulmonary Blood Flow ◽  
Anesthetic Management ◽  
Ductus Arteriosus ◽  
Pulmonary Atresia ◽  
Systemic Circulation ◽  
Arterial System ◽  
Pulmonary Vasculature ◽  
Pulmonary Arterial

Tetralogy of Fallot with pulmonary atresia (ToF-PA) is a rare diagnosis that includes an extraordinarily heterogeneous group of complex anatomical findings with significant implications for physiology and prognosis. In addition to the classic findings of ToF, this particular diagnosis is characterized by complete failure of forward flow from the right ventricle to the pulmonary arterial system. As such, pulmonary blood flow is entirely dependent on shunting from the systemic circulation, most frequently via a patent ductus arteriosus, major aortopulmonary collaterals, or a combination of the two. The pathophysiology of ToF-PA is largely attributable to the abnormalities of the pulmonary vasculature. Ultimately, these patients require operative intervention to create a reliable, controlled source of pulmonary blood flow and ideally complete intracardiac repair. Even after operative correction, these patients remain at risk for pulmonary arterial stenoses and pulmonary hypertension. Although there have been significant advances in surgical and interventional management of ToF-PA leading to dramatic improvements in survival and long-term functional status, there is ongoing debate about the optimal management strategy given the risk of development of irreversible abnormalities of the pulmonary vasculature and the morbidity and mortality associated with sometimes multiple, complex operative interventions often occurring early in infancy. This review will discuss the findings in patients with ToF-PA with a focus on the perioperative and anesthetic management and will highlight challenges faced by the anesthesiologist in caring for these patients.

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