eMedicine Specialties > Pediatrics: Cardiac Disease and Critical Care Medicine > Cardiology

Tetralogy of Fallot With Absent Pulmonary Valve: Follow-up

Author: Prema Ramaswamy, MD, Co-director of Pediatric Cardiology, Maimonides Medical Center; Assistant Professor, Department of Pediatrics, Mount Sinai School of Medicine
Coauthor(s): Kurt Pflieger, MD, FAAP, Active Staff, Department of Pediatrics, Lake Pointe Medical Center
Contributor Information and Disclosures

Updated: Jul 17, 2008

Follow-up

Further Outpatient Care

  • Surgical repair aneurysmal pulmonary arteries in infants does not necessarily eliminate respiratory symptoms. These patients require close and regular outpatient follow-up.
  • Patients in whom repair is successful require regular outpatient visits to monitor right ventricular function, hemodynamics of the homograft, if used, and cardiac rhythm stability.

Transfer

  • Transfer to a tertiary care facility with pediatric critical care specialists, pediatric cardiologists, and pediatric cardiothoracic surgeons is expected.

Complications

Prognosis

  • Neonates with severe respiratory distress soon after birth are most at risk for early death.
  • Infants who require surgery early in life have a worse prognosis than those repaired at a later date.
  • Prognosis is directly related to the degree of tracheobronchial obstruction secondary to pulmonary artery dilatation.

Patient Education

Miscellaneous

Medicolegal Pitfalls

  • Failure to refer a patient with cardiopulmonary embarrassment to a specialty center constitutes a departure from standard of care.
  • Failure to recognize the presence of a cardiac defect by failing to perform a satisfactory physical examination in a patient with symptoms of respiratory distress is a pitfall.
 


More on Tetralogy of Fallot With Absent Pulmonary Valve

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References
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References

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Further Reading

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Keywords

tetralogy of Fallot, TOF, absent pulmonary valve syndrome, TOF with absent pulmonary valve, Fallot tetralogy, Fallot's tetralogy, Fallot tetrad, Fallot's tetrad, ventricular septal defect, infundibular pulmonary stenosis, pulmonary regurgitation, cyanotic heart disease, hypoxemia, heart failure, respiratory failure, patent ductus arteriosus

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Contributor Information and Disclosures

Author

Prema Ramaswamy, MD, Co-director of Pediatric Cardiology, Maimonides Medical Center; Assistant Professor, Department of Pediatrics, Mount Sinai School of Medicine
Prema Ramaswamy, MD is a member of the following medical societies: American Academy of Pediatrics and American College of Cardiology
Disclosure: Nothing to disclose.

Coauthor(s)

Kurt Pflieger, MD, FAAP, Active Staff, Department of Pediatrics, Lake Pointe Medical Center
Kurt Pflieger, MD, FAAP is a member of the following medical societies: American Academy of Pediatrics, American College of Emergency Physicians, American Heart Association, and Texas Medical Association
Disclosure: Nothing to disclose.

Medical Editor

Ira H Gessner, MD, Professor Emeritus, Pediatric Cardiology
Ira H Gessner, MD is a member of the following medical societies: American Academy of Pediatrics, American College of Cardiology, American Heart Association, American Pediatric Society, and Society for Pediatric Research
Disclosure: Nothing to disclose.

Pharmacy Editor

Mary L Windle, PharmD, Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy, Pharmacy Editor, eMedicine
Disclosure: Pfizer Inc Stock Investment from broker recommendation; Avanir Pharma Stock Investment from broker recommendation

Managing Editor

Julian M Stewart, MD, PhD, Associate Chairman of Pediatrics, Director, Center for Hypotension, Westchester Medical Center; Professor of Pediatrics and Physiology, New York Medical College
Julian M Stewart, MD, PhD is a member of the following medical societies: American Academy of Pediatrics
Disclosure: Nothing to disclose.

CME Editor

Gilbert Herzberg, MD, Assistant Professor, Department of Pediatrics, Section of Pediatric Cardiology, New York Medical College
Gilbert Herzberg, MD is a member of the following medical societies: American Academy of Pediatrics
Disclosure: Nothing to disclose.

Chief Editor

Stuart Berger, MD, Professor of Pediatrics, Division of Cardiology, Medical College of Wisconsin; Chief of Pediatric Cardiology, Medical Director of Pediatric Heart Transplant Program, Medical Director of The Heart Center, Children's Hospital of Wisconsin
Stuart Berger, MD is a member of the following medical societies: American Academy of Pediatrics, American College of Cardiology, American College of Chest Physicians, American Heart Association, and Society for Cardiac Angiography and Interventions
Disclosure: Nothing to disclose.

 
 
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