Hostname: page-component-cd9895bd7-8ctnn Total loading time: 0 Render date: 2024-12-28T06:12:11.470Z Has data issue: false hasContentIssue false

Pulmonary vasodilator therapy in tetralogy of Fallot with pulmonary atresia and major aortopulmonary collaterals: case series and review of literature

Published online by Cambridge University Press:  08 August 2017

Sotiria C. Apostolopoulou*
Affiliation:
Department of Pediatric Cardiology, Onassis Cardiac Surgery Center, Athens, Greece
George Vagenakis
Affiliation:
Department of Pediatric Cardiology, Onassis Cardiac Surgery Center, Athens, Greece
Spyridon Rammos
Affiliation:
Department of Pediatric Cardiology, Onassis Cardiac Surgery Center, Athens, Greece
*
Correspondence to: S. C. Apostolopoulou, MD, PhD, Department of Pediatric Cardiology, Onassis Cardiac Surgery Center, 356 Syngrou Ave, Athens, GR 176 74, Greece. Tel: +30-210-949-3865; Fax: +30-210-949-3853; E-mail: riapos@hol.gr

Abstract

We present the use of pulmonary vasodilators in three adult patients with unrepaired tetralogy of Fallot, pulmonary atresia, aortopulmonary collaterals, and segmental pulmonary arterial hypertension. Patients improved by 1–2 NYHA classes with modest exercise-tolerance increase, and remained stable without side effects during 2.5, 10, and 14 years. Literature review revealed five studies with pulmonary vasodilators in heterogeneous, mostly repaired patient populations.

Type
Brief Report
Copyright
© Cambridge University Press 2017 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1. Malhotra, SP, Hanley, FL. Surgical management of pulmonary atresia with ventricular septal defect and major aortopulmonary collaterals: a protocol-based approach. Semin Thorac Cardiovasc Surg Pediatr Card Surg Annu 2009; 145151.Google Scholar
2. Gatzoulis, MA, Beghetti, M, Galie, N, et al. Longer-term bosentan therapy improves functional capacity in Eisenmenger syndrome: results of the BREATHE-5 open-label extension study. Int J Cardiol 2008; 127: 2732.CrossRefGoogle ScholarPubMed
3. Grant, EK, Berger, JT. Use of pulmonary hypertension medications in patients with tetralogy of Fallot with pulmonary atresia and multiple aortopulmonary collaterals. Pediatr Cardiol 2016; 37: 304312.Google Scholar
4. Lim, ZS, Vettukattill, JJ, Salmon, AP, Veldtman, GR. Sildenafil therapy in complex pulmonary atresia with pulmonary arterial hypertension. Int J Cardiol 2008; 129: 339343.CrossRefGoogle ScholarPubMed
5. Schuuring, MJ, Bouma, BJ, Cordina, R, et al. Treatment of segmental pulmonary artery hypertension in adults with congenital heart disease. Int J Cardiol 2013; 164: 106110.Google Scholar
6. Yamamura, K, Nagata, H, Ikeda, K, Ihara, K, Hara, T. Efficacy of bosentan therapy for segmental pulmonary artery hypertension due to major aortopulmonary collateral arteries in children. Int J Cardiol 2012; 161: e1e3.Google Scholar
7. Yasuhara, J, Yamagishi, H. Pulmonary arterial hypertension associated with tetralogy of Fallot. Int Heart J 2015; 56 (Suppl): S17S21.Google Scholar
8. Shimazaki, Y, Maehara, T, Blackstone, EH, Kirklin, JW, Bargeron, LM Jr.. The structure of the pulmonary circulation in tetralogy of Fallot with pulmonary atresia. A quantitative cineangiographic study. J Thorac Cardiovasc Surg 1988; 95: 10481058.Google Scholar
9. Bull, K, Somerville, J, Ty, E, Spiegelhalter, D. Presentation and attrition in complex pulmonary atresia. J Am Coll Cardiol 1995; 25: 491499.CrossRefGoogle ScholarPubMed
10. Grady, RM, Gandhi, S, Sweet, SC, Mao, J, Huddleston, CB. Dismal lung transplant outcomes in children with tetralogy of Fallot with pulmonary atresia compared to Eisenmenger syndrome or pulmonary vein stenosis. J Heart Lung Transplant 2009; 28: 12211225.CrossRefGoogle ScholarPubMed
11. Schermuly, RT, Pullamsetti, SS, Kwapiszewska, G, et al. Phosphodiesterase 1 upregulation in pulmonary arterial hypertension: target for reverse-remodeling therapy. Circulation 2007; 115: 23312339.Google Scholar
12. Savarese, G, Paolillo, S, Costanzo, P, et al. Do changes of 6-minute walk distance predict clinical events in patients with pulmonary arterial hypertension? A meta-analysis of 22 randomized trials. J Am Coll Cardiol 2012; 60: 11921201.Google Scholar