(IV-5A.O)Patient after corection of Tetralogy of Fallot syndrome with aortic regurgitation Natalia Dłużniewska MD, Lidia Tomkiewicz-Pająk MD PhD, Prof Maria Olszowska MD, PhD, Prof Piotr Podolec MD PhD

BRIEF COMMENTS

EXPERT: Prof. Janusz Skalski, MD PhD, cardiac surgeon
Affiliation: Department of Pediatric Cardiac Surgery, University Children’s Hospital of Krakow, Poland
COMMENT
Mitral regurgitation appears to be the most problematic issue in this case. Is the mitral valve replacement really essential? Echocardiography shows moderate mitral regurgitation, probably conservative treatment is indicated with regular check-ups. Observation if the defect does not worsens. Surgical procedure will be difficult in this patient.

EXPERT: Dr Lidia Tomkiewicz-Pająk, MD PhD, cardiologist
Affiliation: Department of Cardiac and Vascular Diseases, John Paul II Hospital, Krakow, Poland
COMMENT
Vena contracta of mitral regurgitation is 4 mm, which makes it moderate. Left heart chambers aren’t enlarged. Perhaps in the future indications to the aortic valve replacement will appear as well.

EXPERT: Prof. Piotr Podolec, MD PhD, cardiologist
Affiliation: Department of Cardiac and Vascular Diseases, John Paul John Paul II Hospital in Krakow, Poland
COMMENT
Hemodynamic gradients obtained on right heart catheterization aren’t increased, as
they are in echocardiography. Patient needs observation. Perhaps not a replacement but the
plasty of the valve should be considered.

CONCLUSIONS

Patient requires regular follow-up with the evaluation of the exercise capacity (cardiopulmonary exercise test), severity of the mitral regurgitation on the serial echo studies and physical status.

“Development of the European Network in Orphan Cardiovascular Diseases”
„Rozszerzenie Europejskiej Sieci Współpracy ds. Sierocych Chorób Kardiologicznych”