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Repercussões cardiovasculares no adulto : pós reparação de tetralogia de Fallot

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Resumo:Tetralogy of Fallot is the most common form of cyanotic congenital heart disease. After the repair of this heart disease, patients reach adulthood with good quality of life due to technological advancement and better surveillance. However, in the long term, some anatomic and pathophysiological conditions are present and provide morbidity. Pulmonary regurgitation is the most common of them and leads to right ventricular dilation and dysfunction. Also, this is the cause of abnormal interventricular interactions and intrinsecal myocardial changes that lead to arrhythmogenic foci (reentrant circuits). The late complications result in global heart failure or sudden cardiac death (ventricular tachycardia). Dilation of the aortic root and ascending aorta are present due to the increased hemodynamic stress on the aortic wall and histological changes that decrease wall stiffness. This structural defect results in aortic regurgitation and contributes to heart failure. The cardiac magnetic resonance is the gold standard diagnostic procedure for cardiac morphologic and functional assessment. The implantable cardioverter-defibrillators are useful for the prevention of sudden death. The treatment of heart failure should be the most adjusted and the replacement of the pulmonary valve before cardiac irreversible dysfuntion is crucial.
Autores principais:Novo, Maria do Rosário Viana
Assunto:Tetralogia de Fallot Brain natriuretic peptide Comunicação interventricular Substituição da válvula pulmonar Regurgitação pulmonar Ressonância magnética cardiovascular
Ano:2014
País:Portugal
Tipo de documento:dissertação de mestrado
Tipo de acesso:acesso restrito
Instituição associada:Universidade de Lisboa
Idioma:português
Origem:Repositório da Universidade de Lisboa
Descrição
Resumo:Tetralogy of Fallot is the most common form of cyanotic congenital heart disease. After the repair of this heart disease, patients reach adulthood with good quality of life due to technological advancement and better surveillance. However, in the long term, some anatomic and pathophysiological conditions are present and provide morbidity. Pulmonary regurgitation is the most common of them and leads to right ventricular dilation and dysfunction. Also, this is the cause of abnormal interventricular interactions and intrinsecal myocardial changes that lead to arrhythmogenic foci (reentrant circuits). The late complications result in global heart failure or sudden cardiac death (ventricular tachycardia). Dilation of the aortic root and ascending aorta are present due to the increased hemodynamic stress on the aortic wall and histological changes that decrease wall stiffness. This structural defect results in aortic regurgitation and contributes to heart failure. The cardiac magnetic resonance is the gold standard diagnostic procedure for cardiac morphologic and functional assessment. The implantable cardioverter-defibrillators are useful for the prevention of sudden death. The treatment of heart failure should be the most adjusted and the replacement of the pulmonary valve before cardiac irreversible dysfuntion is crucial.