Repaired tetralogy of Fallot: the roles of cardiovascular magnetic resonance in evaluating pathophysiology and for pulmonary valve replacement decision support.
Repaired tetralogy of Fallot: the roles of cardiovascular magnetic resonance in evaluating pathophysiology and for pulmonary valve replacement decision support.
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DOI：
10.1186/1532-429x-13-9
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发表时间：
2011-01-20
期刊：
影响因子：
--
通讯作者：
Geva T
中科院分区：
文献类型：
--
作者：
Geva T
法洛四联症（TOF）的外科治疗导致大多数患者的解剖和功能异常。尽管由于严重肺动脉瓣反流引起的右心室容积负荷可以耐受多年，但现在有证据表明，右心室心肌的代偿机制最终失败，如果肺动脉瓣置换术不能消除或减少容积负荷，则功能障碍可能是不可逆的。在过去的20年中，心血管磁共振（CMR）已经发展成为评估TOF修复患者解剖和功能后遗症的参考标准成像模式。本文综述了TOF修复术后慢性右心室容量负荷的病理生理学以及肺动脉瓣置换术的风险和受益。CMR技术用于全面评估修复TOF患者的审查和CMR的作用，在支持肺动脉瓣置换术的临床决策进行了讨论。
Surgical management of tetralogy of Fallot (TOF) results in anatomic and functional abnormalities in the majority of patients. Although right ventricular volume load due to severe pulmonary regurgitation can be tolerated for many years, there is now evidence that the compensatory mechanisms of the right ventricular myocardium ultimately fail and that if the volume load is not eliminated or reduced by pulmonary valve replacement the dysfunction might be irreversible. Cardiovascular magnetic resonance (CMR) has evolved during the last 2 decades as the reference standard imaging modality to assess the anatomic and functional sequelae in patients with repaired TOF. This article reviews the pathophysiology of chronic right ventricular volume load after TOF repair and the risks and benefits of pulmonary valve replacement. The CMR techniques used to comprehensively evaluate the patient with repaired TOF are reviewed and the role of CMR in supporting clinical decisions regarding pulmonary valve replacement is discussed.