The Clinical Spectrum of Adults with Tetralogy of Fallot: Cardiac and Extra-cardiac Features and Late Outcomes

• Main Author: Piran, Sara
• Other Authors: Silversides, Candice
• Language: en_ca
• Published: 2010
• Subjects: 0564
• Online Access: http://hdl.handle.net/1807/25894

Tetralogy of Fallot (TOF) is a form of complex congenital heart disease (CHD) with clinical and genetic heterogeneity. Of the few known causes, 22q11.2 deletion syndrome is most common. We sought to define other clinical subgroups by focusing on congenital cardiac and extra-cardiac features, and cardiac outcome. Patients were prospectively categorized as “syndromic” if they had at least two of three features: dysmorphic facies, learning difficulties or voice abnormalities. We compared cardiac and extra-cardiac characteristics, and late cardiac outcomes between the syndromic group and a nonsyndromic control group. The syndromic group had a more complex cardiac disease, was at elevated risk for developing later onset conditions including neuropsychiatric disorders, endocrine disorders, and hearing deficits, and had a higher mortality rate compared to the nonsyndromic group. Increased awareness of this subgroup with a multisystem condition may be helpful for optimizing management and identifying individuals for referral to medical genetics.