Frontiers in cardiovascular medicine · 2026
Case Report: Unrepaired Tetralogy of Fallot in a 50-year-Old woman with 13 pregnancies: multimodal cardiovascular imaging, surgical repair, and longitudinal remodeling.
Клинический случайСтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Hattab Moath, Ismail Yahya, Darsalim Ahmed, Deek Nour, Abed Mohammad, Abderrazeq Adham, Abuhaltam Abelhalim, SalahAldin Mohammed, Abutaqa Mohammed, Hijjeh Nizar
Аннотация
BACKGROUND: Survival into adulthood without repair of Tetralogy of Fallot (TOF) is exceedingly rare, with only 3%-5% of patients reaching 40 years without intervention. Cardiovascular imaging is central to establishing late diagnoses and planning complex surgical repair.
CASE SUMMARY: We report a 50-year-old woman with no prior cardiac diagnosis who presented with progressive dyspnea and profound cyanosis. Despite 13 pregnancies and 11 successful deliveries, she had never been evaluated for congenital heart disease. Multimodal cardiovascular imaging, including transthoracic (TTE) and transesophageal echocardiography (TEE), color Doppler, contrast studies, cardiac catheterization, and chest radiography, demonstrated classic TOF anatomy: a large sub-aortic VSD, overriding aorta, severe right ventricular outflow tract (RVOT) obstruction, hypoplastic pulmonary annulus, and secondary right-sided dilation.The patient underwent successful corrective surgery with VSD patch closure, pulmonary valve commissurotomy, and pulmonary artery plasty. Postoperatively, oxygen saturation normalized, and serial echocardiography over 6 months showed substantial reduction in RV/RA dimensions and improvement in peak RVOT gradients, although significant residual RVOT obstruction persisted at 6 months. (RV diameter 4.38 → 3.98 cm, RA area 23.4 → 17.9 cm², RVOT gradient 124 → 67 mmHg).
CONCLUSION: This case highlights the diagnostic value of multimodal cardiovascular imaging in detecting unrecognized cyanotic congenital heart disease in adults and demonstrates that late TOF repair can be safe and effective. It underscores the need for routine interpretation of unexpectedly low oxygen saturation in adults and strengthened awareness among cardiologists, echocardiographers, and general physicians of congenital heart disease beyond childhood.
CASE SUMMARY: We report a 50-year-old woman with no prior cardiac diagnosis who presented with progressive dyspnea and profound cyanosis. Despite 13 pregnancies and 11 successful deliveries, she had never been evaluated for congenital heart disease. Multimodal cardiovascular imaging, including transthoracic (TTE) and transesophageal echocardiography (TEE), color Doppler, contrast studies, cardiac catheterization, and chest radiography, demonstrated classic TOF anatomy: a large sub-aortic VSD, overriding aorta, severe right ventricular outflow tract (RVOT) obstruction, hypoplastic pulmonary annulus, and secondary right-sided dilation.The patient underwent successful corrective surgery with VSD patch closure, pulmonary valve commissurotomy, and pulmonary artery plasty. Postoperatively, oxygen saturation normalized, and serial echocardiography over 6 months showed substantial reduction in RV/RA dimensions and improvement in peak RVOT gradients, although significant residual RVOT obstruction persisted at 6 months. (RV diameter 4.38 → 3.98 cm, RA area 23.4 → 17.9 cm², RVOT gradient 124 → 67 mmHg).
CONCLUSION: This case highlights the diagnostic value of multimodal cardiovascular imaging in detecting unrecognized cyanotic congenital heart disease in adults and demonstrates that late TOF repair can be safe and effective. It underscores the need for routine interpretation of unexpectedly low oxygen saturation in adults and strengthened awareness among cardiologists, echocardiographers, and general physicians of congenital heart disease beyond childhood.