[Chronic pulmonary insufficiency after tetralogy of Fallot and pulmonary stenosis intervention. Pulmonary valve replacement with mechanical prosthesis]. / Insuficiencia pulmonar crónica secundaria a tetralogía de Fallot y estenosis pulmonar intervenida. Recambio valvular pulmonar con prótesis metálica.

INTRODUCTION: Tetralogy of Fallot and pulmonary stenosis are a frequent cause of consultation in patients with congenital heart disease. Interventions performed in infancy can cause residual pulmonary insufficiency and may require pulmonary valve replacement when adults. METHODS: From 2003 to 2007, 37 patients underwent right ventricular outflow tract or pulmonary valve intervention (tetralogy of Fallot and pulmonary stenosis). Differences between echocardiographic parameters in both pathologies, indications for pulmonary valvular replacement and the type of prosthesis used, were studied. RESULTS: 25 (67.6 %) patients had tetralogy of Fallot and 12 (32.4 %) pulmonary stenosis. In the pulmonary stenosis group, 7 patients had pulmonary valvulotomy in infancy and 5 had percutaneous pulmonary valvuloplasty in adulthood. Fallot patients received a transannular patch. No significant differences were seen in echocardiographic parameters (right and left ventricular diameter, pulmonary insufficiency, transpulmonary gradient and left ventricular ejection fraction). Mechanical prosthesis valve replacement was performed in 5 (13.5 %) patients, with no morbidity-mortality and with a significant improvement of the functional class. CONCLUSIONS: Chronic pulmonary insufficiency is a frequent complication after intervention of tetralogy of Fallot and pulmonary stenosis. Mechanical prosthesis valve replacement has low morbidity-mortality and low risk of complications after short to medium-term follow-up.

Insuficiencia pulmonar crónica secundaria a tetralogía de Fallot y estenosis pulmonar intervenida. Recambio valvular pulmonar con prótesis metálica / Chronic pulmonary insufficiency after tetralogy of Fallot and pulmonary stenosis intervention. Pulmonary valve replacement with mechanical prosthesis

Introducción. La tetralogía de Fallot y la estenosis pulmonar intervenida son causas frecuentes de consulta en pacientes con cardiopatías congénitas. Las intervenciones realizadas en la infancia conllevan una insuficiencia pulmonar residual que puede requerir recambio valvular pulmonar en la edad adulta. Métodos. Entre 2003 y 2007 se controló a 37 pacientes con intervencionismo sobre el tracto de salida del ventrículo derecho y la válvula pulmonar (tetralogía de Fallot y estenosis pulmonar). Se realizó un estudio para evaluar la diferencia entre los parámetros ecocardiográficos de ambas patologías, las indicaciones de recambio valvular pulmonar y el tipo de prótesis implantada. Resultados. Del total de pacientes con intervención sobre la válvula pulmonar, 25 (67,6 %) tenían tetralogía de Fallot y 12 (32,4 %), estenosis pulmonar. De los pacientes con estenosis pulmonar, a 7 se les realizó valvulotomía en la infancia y a 5, valvuloplastia pulmonar en la edad adulta. A los pacientes con tetralogía de Fallot se les realizó una ampliación transanular con parche. La diferencia de medias de los parámetros ecocardiográficos estudiados (diámetros de los ventrículos derecho e izquierdo, grado de insuficiencia pulmonar, gradiente transpulmonar y fracción de eyección del ventrículo izquierdo) no fue significativa. Se realizó recambio valvular pulmonar con prótesis metálica en 5 (13,5 %) pacientes, sin morbimortalidad y con una mejoría significativa del grado funcional. Conclusiones. La insuficiencia pulmonar crónica es una complicación frecuente en los pacientes con tetralogía de Fallot y estenosis pulmonar intervenidas. El recambio pulmonar con prótesis metálica es un procedimiento de baja morbimortalidad y escaso riesgo de complicaciones a corto-medio plazo

Introduction. Tetralogy of Fallot and pulmonary stenosis are a frequent cause of consultation in patients with congenital heart disease. Interventions performed in infancy can cause residual pulmonary insufficiency and may require pulmonary valve replacement when adults. Methods. From 2003 to 2007, 37 patients underwent right ventricular outflow tract or pulmonary valve intervention (tetralogy of Fallot and pulmonary stenosis). Differences between echocardiographic parameters in both pathologies, indications for pulmonary valvular replacement and the type of prosthesis used, were studied. Results. 25 (67.6 %) patients had tetralogy of Fallot and 12 (32.4 %) pulmonary stenosis. In the pulmonary stenosis group, 7 patients had pulmonary valvulotomy in infancy and 5 had percutaneous pulmonary valvuloplasty in adulthood. Fallot patients received a transannular patch. No significant differences were seen in echocardiographic parameters (right and left ventricular diameter, pulmonary insufficiency, transpulmonary gradient and left ventricular ejection fraction). Mechanical prosthesis valve replacement was performed in 5 (13.5 %) patients, with no morbidity-mortality and with a significant improvement of the functional class. Conclusions. Chronic pulmonary insufficiency is a frequent complication after intervention of tetralogy of Fallot and pulmonary stenosis. Mechanical prosthesis valve replacement has low morbidity-mortality and low risk of complications after short to medium-term follow-up

[Congenital heart diseases and sports]. / Cardiopatías congénitas y deporte.

Congenital heart diseases are a frequent cause of cardiology consultation. New diagnostic and therapeutic techniques have allowed greater survival and quality of life of patients who wish to participate in sports. What they can do is not always easy to determine. Guidelines are helpful at the time of deciding, although finally is the doctor the one that must determine in each case the situation of the patient and the type of exercise they can do depending on the severity and type of cardiopathy.

Cardiopatías congénitas y deporte / Congenital heart diseases and sport

Las cardiopatías congénitas constituyen cada vez más una causa frecuente de consulta cardiológica. Las nuevas técnicas diagnósticas y terapéuticas han permitido mayor supervivencia y calidad de vida de unos pacientes que desean realizar deporte. Hasta donde pueden llegar no es siempre fácil de determinar. Las guías nos ayudan a la hora de decidir, aunque finalmente es el médico el que debe determinar en cada caso la situación del paciente y el tipo de deporte que podrá realizar dependiendo de la severidad y el tipo de cardiopatía

Congenital heart diseases are a frequent cause of cardiology consultation. New diagnostic and therapeutic techniques have allowed greater survival and quality of life of patients who wish to participate in sports. What they can do is not always easy to determine. Guidelines are helpful at the time of deciding, although finally is the doctor the one that must determine in each case the situation of the patient and the type of exercise they can do depending on the severity and type of cardiopathy