Key result
Adult cardiac surgery patients show ~4% prevalence of right ventricular outflow tract obstruction, primarily non-congenital.
Why the study?
Adults with corrected Tetralogy of Fallot are at risk of sudden death due to arrhythmias and congestive heart disease from residual lesions, but the prevalence and etiology of right ventricular outflow tract obstruction (RVOTO) in this population are not well characterized.
Meta-Analysis (n=1,413)
May warrant consideration during adult cardiac surgery evaluation; leaves open need for prospective validation and outcome studies.
Adults with congenital heart diseases are an increasing patient population. Since the first successful palliative procedure in 1945 (Blalock and Tausing, JAMA 128: 189-194, 1945) and first corrective operation in 1955 (Lillehei et al., Ann Surg 142: 418, 1955) patients with Tetralogy of Fallot, which is the most common cyanotic CHD, have had excellent long term results and good quality of life. Over the long term, these patients are under risk of sudden death because of arrhythmias and congestive heart disease caused by tricuspid regurgitation, pulmonary regurgitation, ventricular septal defect, right ventricular outflow tract obstruction.
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Coskun et al. (2008) conducted a meta-analysis in Right ventricular outflow tract obstruction (RVOTO) (n=1,413). Cardiac surgery was evaluated on Prevalence of right ventricular outflow tract obstruction (95% CI 1-9). The estimated prevalence of right ventricular outflow tract obstruction in the adult cardiac surgery population was 4.0%, with the most common etiologies being non-congenital and non-iatrogenic.
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