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Review

Repaired Tetralogy of Fallot: Have We Understood the Right Timing of PVR?

by
Benedetta Leonardi
1,*,
Marco Perrone
2,3,
Giuseppe Calcaterra
4,
Jolanda Sabatino
5,
Isabella Leo
5,
Martina Aversani
6,
Pier Paolo Bassareo
7,
Alice Pozza
6,
Lilia Oreto
8,
Sara Moscatelli
9,
Nunzia Borrelli
10,
Francesco Bianco
11 and
Giovanni Di Salvo
6 on behalf of the Working Group on Congenital Heart Disease, Cardiovascular Prevention in Paediatric Age of the Italian Society of Cardiology (SIC)
1
Bambino Gesù Children’s Hospital, IRCCS, 00165 Rome, Italy
2
Clinical Pathways and Epidemiology Unit, Bambino Gesù Children’s Hospital, IRCCS, 00165 Rome, Italy
3
Division of Cardiology and CardioLab, Department of Clinical Sciences and Translational Medicine, University of Rome Tor Vergata, 00133 Rome, Italy
4
Department of Cardiology, University of Palermo, 90133 Palermo, Italy
5
Department of Experimental and Clinical Medicine, Magna Graecia University, 88100 Catanzaro, Italy
6
Paediatric Cardiology and Congenital Heart Disease, University of Padua and Pediatric Research Institute (IRP), Città Della Speranza, 35127 Padua, Italy
7
School of Medicine, University College of Dublin, Mater Misericordiae University Hospital, D07 R2WY Dublin, Ireland
8
Dipartimento di Medicina Clinica e Sperimentale, Università di Messina, 98122 Messina, Italy
9
Institute of Cardiovascular Sciences University College London, London WC1E 6BT, UK and Centre for Inherited Cardiovascular Diseases, Great Ormond Street Hospital, London WC1N 3JH, UK
10
Adult Congenital Heart Disease Unit, AO Dei Colli, Monaldi Hospital, 80131 Naples, Italy
11
Cardiovascular Sciences Department, AOU “Ospedali Riuniti”, 60126 Ancona, Italy
 
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Author to whom correspondence should be addressed.
J. Clin. Med. 2024, 13(9), 2682; https://doi.org/10.3390/jcm13092682
Submission received: 17 March 2024 / Revised: 23 April 2024 / Accepted: 26 April 2024 / Published: 2 May 2024
(This article belongs to the Special Issue Clinical Applications of Novel Tools to Personalize the Follow-Up and Predict the Outcomes in Congenital Heart Disease)
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Abstract

Despite many advances in surgical repair during the past few decades, the majority of tetralogy of Fallot patients continue to experience residual hemodynamic and electrophysiological abnormalities. The actual issue, which has yet to be solved, is understanding how this disease evolves in each individual patient and, as a result, who is truly at risk of sudden death, as well as the proper timing of pulmonary valve replacement (PVR). Our responsibility should be to select the most appropriate time for each patient, going above and beyond imaging criteria used up to now to make such a clinically crucial decision. Despite several studies on timing, indications, procedures, and outcomes of PVR, there is still much uncertainty about whether PVR reduces arrhythmia burden or improves survival in these patients and how to appropriately manage this population. This review summarizes the most recent research on the evolution of repaired tetralogy of Fallot (from adolescence onwards) and risk factor variables that may favor or delay PVR.
Keywords: tetralogy of Fallot; PVR; pulmonary insufficiency tetralogy of Fallot; PVR; pulmonary insufficiency

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MDPI and ACS Style

Leonardi, B.; Perrone, M.; Calcaterra, G.; Sabatino, J.; Leo, I.; Aversani, M.; Bassareo, P.P.; Pozza, A.; Oreto, L.; Moscatelli, S.; et al. Repaired Tetralogy of Fallot: Have We Understood the Right Timing of PVR? J. Clin. Med. 2024, 13, 2682. https://doi.org/10.3390/jcm13092682

AMA Style

Leonardi B, Perrone M, Calcaterra G, Sabatino J, Leo I, Aversani M, Bassareo PP, Pozza A, Oreto L, Moscatelli S, et al. Repaired Tetralogy of Fallot: Have We Understood the Right Timing of PVR? Journal of Clinical Medicine. 2024; 13(9):2682. https://doi.org/10.3390/jcm13092682

Chicago/Turabian Style

Leonardi, Benedetta, Marco Perrone, Giuseppe Calcaterra, Jolanda Sabatino, Isabella Leo, Martina Aversani, Pier Paolo Bassareo, Alice Pozza, Lilia Oreto, Sara Moscatelli, and et al. 2024. "Repaired Tetralogy of Fallot: Have We Understood the Right Timing of PVR?" Journal of Clinical Medicine 13, no. 9: 2682. https://doi.org/10.3390/jcm13092682

APA Style

Leonardi, B., Perrone, M., Calcaterra, G., Sabatino, J., Leo, I., Aversani, M., Bassareo, P. P., Pozza, A., Oreto, L., Moscatelli, S., Borrelli, N., Bianco, F., & Di Salvo, G., on behalf of the Working Group on Congenital Heart Disease, Cardiovascular Prevention in Paediatric Age of the Italian Society of Cardiology (SIC). (2024). Repaired Tetralogy of Fallot: Have We Understood the Right Timing of PVR? Journal of Clinical Medicine, 13(9), 2682. https://doi.org/10.3390/jcm13092682

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