CONGENITAL – Commentary|Articles in Press

Commentary: The Many Shades of Gradient After Repair of Tetralogy of Fallot

  • Sitaram M. Emani
    Address reprint requests to Sitaram M. Emani, MD, Department of Cardiac Surgery, Boston Children's Hospital, 300 Longwood Ave, Boston, MA 0211.5.
    Department of Cardiac Surgery, Boston Children's Hospital, Boston, Massachusetts
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Published:January 31, 2023DOI:
      Gradient decreases after tetralogy of Fallot repair. Another piece of the very complicated puzzle.
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        • Stephens EH
        • Goldstone AB
        • et al.
        The American Association for Thoracic Surgery (AATS) 2022 Expert Consensus Document: Management of infants and neonates with tetralogy of Fallot.
        J Thorac Cardiovasc Surg. 2023; 165: 221-250
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        • Ram Kumar S
        Fate of the right ventricular outflow tract following valve-sparing repair of tetralogy of Fallot.
        Semin Thorac Cardiovasc Surg. 2022; (in press)
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        Valve-sparing repair with intraoperative balloon dilation in tetralogy of Fallot: Midterm results and therapeutic implications.
        J Thorac Cardiovasc Surg. 2018; 155 (e4): 1163-1173
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        • et al.
        Pulmonary valve reconstruction after annular augmentation in severe forms of tetralogy of Fallot.
        J Thorac Cardiovasc Surg. 2019; 158: e53-e55

      Linked Article

      • Fate of the Right Ventricular Outflow Tract Following Valve-Sparing Repair of Tetralogy of Fallot
        Seminars in Thoracic and Cardiovascular Surgery
        • Preview
          Valve-sparing repair (VSR) of tetralogy of Fallot (TOF) tends to result in higher residual right ventricular outflow tract (RVOT) gradients. We evaluated the progression and clinical implications of RVOT gradients following VSR of TOF. Demographic, clinical, and operative data were retrospectively collected from consecutive TOF patients who underwent VSR at our institution between 01/2010 and 06/2021. RVOT gradient, pulmonary valve annulus (PVA) diameter and Boston Z-scores were recorded from serial echocardiograms.
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