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Clinical Research Study
Research Goal:Test a new way to look at the right side of theheart by new ECHO technology and compare that with MRI
e stu y v s t w ast approx mate y ours an nvo ves acardiac MRI and ECHO
9 years old and up with Tetralogy of Fallot No devices such as ICD or Pacemaker
No RV to PA conduit For more information contact T. Aaron West at
[email protected] call (614)355-3448
Research incentive offered
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Tetralogy of FallotPast, Present, Future
. ,
Coordinator, COACH Program
Columbus Ohio Adult Congenital Heart
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1980 90
1970 Year
75
1960
Born with
CHD40
1940 20
0 10 20 30 40 50 60 70 80 90 100
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Pediatric to Adult Congenital Heart
seaseExpanding Population of
A o escents an A u ts
with CHDIncreased Mid TermSurvival
Increased Early
SurvivalLower Perioperative
MortalityEarly Complete
RepairImproved Surgical
Techniques
Incidence of CHD
vNICU Care
Fetal Diagnosis
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Ratio of Pediatric to Adult Patients
with CHD
Pediatric patientsAdult patients
1965 1985 2005
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ETIENNE-LOUIS ARTHUR FALLOT
Mixing red and
blue blood
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A Success StoryBlalock-Taussig-
Thomas and Blue Baby Syndrome
Alfred Blalock, MD Vivien Thomas Helen Taussig, MD
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On November 29, 1944, Drs. Blalock and Taussig decided to proceed with the anastomosis, or joining, of
the subclavian arter to the ulmonar arter in a c anotic child.
Dr. Helen Taussig was convinced that the operation would help the patient, and despite the technicalproblems of operating on a very small and very ill child, Dr. Alfred Blalock's skill was equal to the task.Blalock worked with his surgical team and his invaluable assistantVivien T. Thomas,who stood behind
.The tiny child who had been at such great risk survived the operation and slowly improved. Over the
succeeding days she gradually became less blue. By the end of the second postoperative week itwas clear she would recover.
When I saw Eileen for the first time, it was like a miracle...I was beside myself with happiness.
--mother of the first child to receive a Blalock-Taussi -Thomas shunt
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ournal of the American Medical Association
May 19, 1945
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Surgical Procedure Description of Surgery Results
Surgical Repairs in Tetralogy of Fallot
Pulmonary valvotomy Opening-up of a
stenotic pulmonary valve
Augments blood flow to the lungs
Infundibular resection Removal of muscular tissue
below the pulmonary valve
Augments blood flow to the lungs
RVOT atch Patch laced across the
RVOT
Transannular patch Patch placed across the
narrowed pulmonary valveDisrupts the pulmonary valve; may result
in severe pulmonary valve leaking
Pulmonary valve replacement Human or porcine (pig) tissue Used in adolescents and adults to treat
original pulmonary valve
Extracardiac conduit Conduit (or tube) connecting
the right ventricle to the
pulmonary artery
Treatment of pulmonary atresia
augmentation
pulmonary artery or stenosis of centralpulmonary arteries
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--
Direct Vision Intracardiac Surgical Correction of the Tetralogy
of Fallot, Pentalogy of Fallot, and Pulmonary Atresia Defects
Report of First Ten Cases
. , . ., , . ., . , . .,
RAYMOND C. READ, M.D., JOSEPH B. AUST, M.D., RICHARD A. DEWALL, M.D.,
AND RICHARD L. VARCO, M.D.
Minneapolis, Minn.
From the Department of Surgery, University of Minnesota Medical School, Minneapolis
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Cross-Circulation as the first heart-lung
machine
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Leakin of the ulmonar valve
Enlargement of the right ventricleWeakening of the right ventricle
Right sided heart failure
Narrowing of the lung arteriesNeed for multiple operations during lifetime
Arrhythmias
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Stent therapy of a narrowed pulmonary
artery
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What does the human PV look like?
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Pulmonary HomograftPericardial valve
ancoc va ve con u t
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Transcatheter pulmonary valve
rep acement
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Melody valve inside tissue valve
Tissue valve narrowed
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The Melody pulmonary valve
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Limitations of the Melody Transcatheter
u monary a ve
The Melod TPV onl can treat 15% of the atients that need it(only 15% have RV PA Conduit)
What about the 85% of patients with native RVOT reconstruction
1st in ManPhilip Bonhoeffer, GOSH, London
Native Outflow Tract TPV Clinical Research Centers wererecently selected
NCH/OSU was chosen as the USA site, while TorontoSick Kids chosen for Canada, and Munich chosen for
Europeto be started in 1st quarter 2012
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First in Man: Philip BonhoefferFirst in Man: Philip Bonhoeffer
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Native right ventricular
ou ow rac s en va ve
Adapts to irregularities
of patient anatomy
Increases access tonon- surgical care for
many patients.
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Enough technologywhat about living
w t tetra ogy o a ot
At least 90% survival 30 ears after o eration
Studies indicate that academic achievement is average or above
Generally satisfied with life
May be somewhat underemployed
Severity of congenital heart disease is not associated with lowerqua y o e
Pregnancy can be safe and successful with appropriate care
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Living Long and Well with tetralogy of
a ot
Regular follow-up with ACHD team Routine physical exam, ECG, oximetry
Echocardiogram to monitor heart function and
blood flow through pulmonary valve
er o c o ter mon tor to oo or arr yt m as
We may recommend MRI or CT Scans to get moredetailed information about our heart
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Living Long and Well with tetralogy of
a ot
ou may nee car ac ca e er za on o eva ua e an
treat: Narrowin in the ulmonar arter
Arrhythmias (Ablation)
You may need to have more surgery
Pacemaker / ICD placement
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Living Long and Well with tetralogy of
a ot
Listen to our bod
Call us with any symptoms or concerns Take your medications as prescribed
Avoid tobacco products
Get regular exercise Eat healthy
Fruits and vegetables
o e gra ns Go easy on fats, processed carbohydrates and salt
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What does the future hold for people with
tetra ogy o a ot
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May you live long andwell enough to visit
the Golden Years
Clinic on Century
quare or p een
Readjustment and
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