TYK213
Following repair of CHD in childhood, the adult patient may present with many residual defects and sequelae. All of the following statements are correct EXCEPT:
a) The commonest cause of death is cardiac failure
b) After coarctation of aorta repair, most patients will develop hypertension
c) Sudden cardiac death following tetralogy of Fallot repair occurs due to arrhythmias or pulmonary stenosis
d) If cyanosis develops in a patient with a left-to-right shunt, life expectancy falls to 6 years from this new finding
e) Arrhythmias are more common in those patients with previous ventriculotomy scars or dilated right heart.
Answer
Answer c. Cardiac failure is the commonest cause of mortality in adult CHD, causing 75% of deaths. Coarctation of the aorta leads to hypertension in 70% of patients with repaired lesions. Reversal of flow in left-to-right shunt lesions is seen in Eisenmenger’s Syndrome with a life expectancy of 6 years from diagnosis. Previous ventriculotomy scars and dilated right ventricles predispose to arrhythmias. The natural history of tetralogy of Fallot depends upon the degree of RVOT obstruction; a pulmonary transannular patch is commonly used, and this will result in pulmonary regurgitation, not stenosis.
Notes
- This question originally printed in the Pediatric Anesthesiology Review Topics kindle book series, and appears courtesy of Naerthwyn Press, LLC.