Pilato Rosario, Lacroix Dominique, Domanski Olivia, Godart François
CHRU de Lille, hôpital cardiologique, service des maladies cardiovasculaires infantiles et congénitales, boulevard Pr.-Leclercq, 59037 Lille cedex, France.
University Lille, faculté de médicine, 59000 Lille, France; CHRU de Lille, hôpital cardiologique, service de cardiologie, boulevard Pr.-Leclercq, 59037 Lille cedex, France.
Presse Med. 2017 Jun;46(6 Pt 1):586-593. doi: 10.1016/j.lpm.2017.02.006. Epub 2017 Jun 2.
Tetralogy of Fallot is a frequent congenital heart disease that has been repaired since the mid-1950s. The follow-up after repair is good despite a persistent risk of sudden death. The risk factors in long-term follow-up are advanced age at repair, hemodynamic status of the right ventricle, QRS duration≥180ms, left ventricular dysfunction, and existence of sustained or not ventricular tachycardia. In the presence of significant pulmonary regurgitation, it is necessary to perform revalvulation either by classic surgery or cardiac catheterization. To correct the risk of ventricular arrhythmia, some have proposed radiofrequency ablation of critical isthmus, or cryo-application during surgery. However, the use of implantable cardioverter defibrillator is another therapeutic option that is more and more employed as secondary or primary prevention in patients at risk of sudden death.
法洛四联症是一种常见的先天性心脏病，自20世纪50年代中期以来一直可进行修复治疗。尽管存在猝死的持续风险，但修复后的随访情况良好。长期随访中的风险因素包括修复时的高龄、右心室的血流动力学状态、QRS时限≥180毫秒、左心室功能障碍以及持续性或非持续性室性心动过速的存在。在存在严重肺动脉反流的情况下，有必要通过经典手术或心导管插入术进行瓣膜置换。为纠正室性心律失常的风险，一些人提议对关键峡部进行射频消融，或在手术期间进行冷冻治疗。然而，植入式心脏复律除颤器的使用是另一种治疗选择，在有猝死风险的患者中越来越多地被用作二级或一级预防。
