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Original Article
Cardiology
Importance of pulmonary valve morphology for pulmonary valve preservation in tetralogy of Fallot surgery: comparison of the echocardiographic parameters
Su Jin Choi, Jung Eun Kwon, Da Eun Roh, Myung Chul Hyun, Hanna Jung, Young Ok Lee, Joon Yong Cho, Yeo Hyang Kim
Clin Exp Pediatr. 2020;63(5):189-194.   Published online November 8, 2019
Question: Is echocardiographic examination is useful for surgical method decision in patients with tetralogy of Fallot (TOF)?
Finding: Various echocardiographic parameters serve as predictors for determining surgical methods for TOF patients. However, the PV morphology and tissue characteristics should also be considered.
Meaning: A full dependence on the size of the pulmonary valve annulus (PVA), the z score, and the ratio of the size of PVA to aortic valve annulus or descending aorta surgery may result in inadequate surgical results during TOF total correction.
The change of QRS duration after pulmonary valve replacement in patients with repaired tetralogy of Fallot and pulmonary regurgitation
Yuni Yun, Yeo Hyang Kim, Jung Eun Kwon
Clin Exp Pediatr. 2018;61(11):362-365.   Published online October 24, 2018

Purpose: This study aimed to analyze changes in QRS duration and cardiothoracic ratio (CTR) following pulmonary valve replacement (PVR) in patients with tetralogy of Fallot (TOF). Methods: Children and adolescents who had previously undergone total repair for TOF (n=67; median age, 16 years) who required elective PVR for pulmonary regurgitation and/or right ventricular out tract obstruction were included in this study....
Outcome of neonatal palliative procedure for pulmonary atresia with ventricular septal defect or tetralogy of Fallot with severe pulmonary stenosis: experience in a single tertiary center
Tae Kyoung Jo, Hyo Rim Suh, Bo Geum Choi, Jung Eun Kwon, Hanna Jung, Young Ok Lee, Joon Yong Cho, Yeo Hyang Kim
Clin Exp Pediatr. 2018;61(7):210-216.   Published online July 15, 2018

Purpose: The present study aimed to evaluate progression and prognosis according to the palliation method used in neonates and early infants aged 3 months or younger who were diagnosed with pulmonary atresia with ventricular septal defect (PA VSD) or tetralogy of Fallot (TOF) with severe pulmonary stenosis (PS) in a single tertiary hospital over a period of 12 years. Methods: Twenty...
Review Article
Primary repair of symptomatic neonates with tetralogy of Fallot with or without pulmonary atresia
Chang-Ha Lee, Jae Gun Kwak, Cheul Lee
Clin Exp Pediatr. 2014;57(1):19-25.   Published online January 31, 2014

Recently, surgical outcomes of repair of tetralogy of Fallot (TOF) have improved. For patients with TOF older than 3 months, primary repair has been advocated regardless of symptoms. However, a surgical approach to symptomatic TOF in neonates or very young infants remains elusive. Traditionally, there have been two surgical options for these patients: primary repair versus an initial aortopulmonary shunt...

Pulmonary stenosis and pulmonary regurgitation: both ends of the spectrum in residual hemodynamic impairment after tetralogy of Fallot repair
Byung Won Yoo, Han Ki Park
Clin Exp Pediatr. 2013;56(6):235-241.   Published online June 21, 2013

Repair of tetralogy of Fallot (TOF) has shown excellent outcomes. However it leaves varying degrees of residual hemodynamic impairment, with severe pulmonary stenosis (PS) and free pulmonary regurgitation (PR) at both ends of the spectrum. Since the 1980s, studies evaluating late outcomes after TOF repair revealed the adverse impacts of residual chronic PR on RV volume and function; thus, a...

Original Article
Late aortic root dilatation and aortic regurgitation in repaired tetralogy of fallot
Jeong Eun Kim, Kyong Hur, Hae Sik Kwon, Byung Won Yoo, Jae Young Choi, Jun Hee Sul
Clin Exp Pediatr. 2007;50(10):976-981.   Published online October 15, 2007
Purpose : Aortic valve or aortic root (AoRo) replacement is occasionally required because of AoRo dilatation and aortic regurgitation (AR) in repaired tetralogy of Fallot (TOF). We evaluated AoRo size and possible factors associated with its hemodynamic nature in patients with repaired TOF. Methods : We investigated 130 repaired TOF patients more than 15 years of age who followed-up by...
The changes of electrocardiography and signal-averaged electrocardiography after surgical repair of Tetralogy of Fallot
Hye-Eun Seo, Hae-Ri Lim, Yeo-Hyang Kim, Myung-Chul Hyun, Sang-Bum Lee
Clin Exp Pediatr. 2007;50(5):462-468.   Published online May 15, 2007
Purpose : The purpose of this study was to analyze the changes of the late potential of Signal- averaged electrocardiography (SAECG) and Electrocardiography (ECG) parameters during follow up of those who had taken surgical repair of Tetralogy of Fallot (TOF). Methods : Nine patients who had taken surgical repair of TOF since 1985 checked SAECG and standard 12 leads ECG twice...
Early and mid-term results of pulmonary valve reconstruction in surgical repair of tetralogy of Fallot; comparison with other techniques of right ventricular outflow reconstruction
Sheng Wen Wang, Young Seok Lee, Si Ho Kim, Tae Hong Kim, Ji Eun Ban, Hyoung Doo Lee, Yun Hee Chang, Si Chan Sung
Clin Exp Pediatr. 2006;49(6):635-642.   Published online June 15, 2006
Purpose : The purpose of this study is to determine whether the new pulmonary valve reconstruction technique prevents short-term postoperative pulmonary regurgitation and improves early and mid-term clinical outcome. Methods : We reviewed postoperative echocardiographic variables and chest X-ray films from 31 patients who had undergone valve reconstruction(pulmonary valve reconstruction group : PVR) for the repair of TOF between April 2000...
Follow-up in Adult after Total Repair of Tetralogy of Fallot
Gi Young Jang, Sun Young Kim, Joo Ryung Moon, Joon Huh, I-Seok Kang, Seung Woo Park, Tae Gook Jun, Pyo Won Park, Heung Jae Lee
Clin Exp Pediatr. 2003;46(7):661-667.   Published online July 15, 2003
Purpose : This study was performed to find the chief clinical problems associated with the ages of adult patients of tetralogy of Fallot(TOF) who had undergone total correction. Methods : Of the 30 patients who were registered at the Grown-Up Congenital Heart Disease (GUCH) Clinic of Samsung Medical Center for TOF, a retrospective investigation was carried out on 28 patients who...
Case Report
Pulmonary Valve Absence and Tetralogy of Fallot in CATCH 22
Hye-Young Ryu, Byoung-Lo Jin, Jin-Man Kim, Hong-Ryang Kil
Clin Exp Pediatr. 2002;45(1):137-140.   Published online January 15, 2002
Congenital absence of the pulmonary valve associated with Tetralogy of Fallot(TOF) is a relatively rare cardiac malformation. In the majority of cases, this lesion is associated with ventricular septal defect, obstructive pulmonary valve annulus, and massive dilatation of the pulmonary arteries. This combination of lesions is often called tetralolgy of Fallot and absent pulmonary valve. Although survival beyond infancy is frequent, a number of...
Original Article
Ventricular Inhomogeneity and Beat-to-beat QT Interval Variability after Surgical Repair of Tetralogy of Fallot
Su-Hyun Kim, Myung-Kul Yum, Nam-Su Kim, Chang-Ryul Kim, Chul-Burm Lee, Chung-Ill Noh, Hee-Soo Kim
Clin Exp Pediatr. 2001;44(4):418-425.   Published online April 15, 2001
Purpose : The object of this study is to determine whether QT interval variability in patients with postoperative tetralogy of Fallot increases. Methods : We enrolled 41 patients who had total correction of tetralogy of Fallot, and 31 healthy controls. They were 6-12 years old. Patients were divided into 2 groups : arrhythmia-positive patients(n=10) who had ventricular premature contractions more than...
Early Results of Stent Implantation in Branch Pulmonary Artery Stenosis after Tetralogy of Fallot Repair
Sung Kyu Lee, Sang Hun Lee, Jae Young Lee, Su Jin Kim, Mi Young Han, Do Jun Cho, In Seung Park, Eun Jung Bae, Sung Ho Kim
Clin Exp Pediatr. 2000;43(10):1343-1349.   Published online October 15, 2000
Purpose : Pulmonary artery stenosis is mainly complicated by aortopulmonary shunt or total correction of tetralogy of Fallot(TOF). Results of surgical angioplasty are poor and the success rate of balloon angioplasty is 53-72%. Endovascular stents have been applied to these lesions. The purpose of this study is to evaluate the early results of stent implantation in postoperative pulmonary artery stenosis...
Morphometric Analysis of the Infundibulum in Tetralogy of Fallot
Su Hee Kwak, Myung Chul Hyun, Sang Bum Lee
Clin Exp Pediatr. 2000;43(9):1187-1191.   Published online September 15, 2000
Purpose : The morphogenic mechanism of tetralogy of Fallot is known to be an antero-superior deviation and hypertrophy of the subpulmonary infundibulum. We performed this study to measure the subpulmonary infundibulum in patients with tetralogy of Fallot and compare those with normal control. Methods : Echocardiographic data and medical reports of 12 patients, with classical tetralogy of Fallot who were diagnosed...
Management of Post-operative Pulmonary Artery Stenosis in Tetralogy of Fallot
Young Seok Lee, In Seung Park, Jae Young Lee, Soo Jin Kim, Mi Young Han, Do Jun Cho, Eun Jung Bae, Seong Ho Kim
Clin Exp Pediatr. 2000;43(8):1081-1089.   Published online August 15, 2000
Purpose : Pulmonary artery stenosis is a common finding in post-operative tetralogy of Fallot (TOF), and it is one of the most frequent indication of reoperation. The objective of this study was to determine the procedural success rate of balloon angioplasty(BAP), endovascular stent, and reoperation for pulmonary artery stenosis in terms of its clinical impact on the subsequent management of...
Depolarization, Repolarization Inhomogeneity and Late Potential after Surgical Repair of Tetralogy of Fallot
Soo Young Kim, Myung Chul Hyun, Sang Bum Lee, Seung Tae Kim, Jong Soo Lee
Clin Exp Pediatr. 1999;42(8):1071-1077.   Published online August 15, 1999
Purpose : After repair of tetralogy of Fallot(TOF), ventricular arrhythmia and sudden death remain as serious late complications which are due to right ventricular systolic and diastolic overloading, exposure to hypoxia and surgical scar. Among the various methods for predicting the risk of such complications, we evaluated signal average ECG(SAECG), QRS duration, QT and JT dispersion, cardiothoracic(CT) ratio, age at...
Autonomic Activity, Cardiac Chaos and Circadian Rhythm in Asymptomatic Children with Postoperative Tetralogy of Fallot
Myung-Kul Yum, Nam-Su Kim, Jae-Won Oh, Chang-Ryul Kim, Chul-Burm Lee, June Huh, Chung-Il Noh
Clin Exp Pediatr. 1998;41(11):1517-1529.   Published online November 15, 1998
Purpose : This study aimed to characterize the autonomic and chaotic control of heart rate and circadian rhythm in asymptomatic patients with postoperative tetralogy of Fallot(pTOF). Methods : Twenty-four-hour electrocardiogram recordings were obtained in 30 asymptomatic pTOF patients and in 30 age-and sex-matched controls, aged between 6 and 11 years. The data was digitized and partitioned into sections of 30-...
Experience of Stent Implantation in Branch Pulmonary Artery Stenosis of the Congenital Heart Diseas
Yong Soo Yun, Eun Jung Cheon, Ho Sung Kim, Chung Il Noh, Jung Yun Choi
Clin Exp Pediatr. 1997;40(3):343-351.   Published online March 15, 1997
Purpose : Branch pulmonary artery stenosis remains a clinically challenging lesion. Results of surgical angioplasty are rarely rewarding, and balloon angioplasty is not uniformly successful. So, endovascular stent has been applied recently to these lesions. But this new modality has not been full yevaluated. The aim of this study is to evaluate the short-term result of stent implantation in postoperative branch pulmonary artery stenosis. Methods :...
Clinical Studiesof Tetralogy of Fallot Associated with Complete Atrioventricular Septal Defect
Min Seop Song, Chung Il Noh, Jung Yun Choi, 서울대학교 의과대학 소아과학교실, Yong Jin Kim
Clin Exp Pediatr. 1996;39(3):354-360.   Published online March 15, 1996
Purpose : The association of the tetralogy of Fallot(TOF) with the complete form of atrioventricular septal defect(AVSD) is rare cardiac malformation.The predominant clinical findings in both groups of cases were those associated with tetralogy of Fallot, but certain features need to be emphasized, however. Methods : Forteen(2%) out of 659 patients with tetralogy of Fallot seen at the department of pediatrics, Seoul...
Echocardiographic Evaluation of the Changes of the Interventricular Septal Morphology in Postoperative Tetralogy of Fallot Patients
Im Jae Park, Jun Hee Sul, Jong-Kyun Lee, Seok Min Choi, Jo Won Chung, Sung Kyu Lee, Bum Koo Cho
Clin Exp Pediatr. 1994;37(4):502-509.   Published online April 15, 1994
The hemodynamic feature of the tetralogy of Fallot (TOF) is best characterized by equality of left and right ventricular peak systolic pressure. The interventricular septum is flattened and thickened. Even after the right ventricular pressure is normalized in the postoperative period, the morphological abnormality continues for some time. We have analyzed the morphological changes of the IVS echocardiographically after total...
Exercise Tolerance Tests in Patients with Tetralogy of Fallot Repaired Earlier : Correlation with 2-Dimensional Echocardiography and Cardiac Catheterization
Jin Yong Lee, Jun Hee Sul, Sung Kyu Lee, Dong Shik Chin, Bum Koo Cho, Soo Kwan Hwang, Dong Soo Yeoun
Clin Exp Pediatr. 1992;35(2):157-167.   Published online February 15, 1992
Exercise tolerance tests were performed using treadmill in 21 patients with tetralogy of Fallot (TOF) repaired earlier (4.8 years in mean) and 10 subjects with small ventricular septal defect or normal heart, aged 8-16 years. Pre and postexercise echocardiography and cardiac catheterization were also performed and the hemodynamic data were compared with exercise parameters. The following results were obtained. 1)...
Echocardiographic Findings in Tetralogy of Fallot.
In Sil Lee
Clin Exp Pediatr. 1982;25(3):321-328.   Published online March 31, 1982
The echocardiographic features of Tetralogy of Fallot were analysed on 102 patients with Tetralogy of Fallot, proven by cardiac catheterization and angiocardiography. The dimension of the cardiac chambers and the relationship of contiguous structures were determined by M-mode scanning technics. The most characteristic echocardiographic finding of Tetralogy of Fallot was abrupt ending of the interventricular septal echoes with the aorta...
Clinical Studies of Tetralogy of Fallot : Factors Affecting Outcome of Operation.
Hong Jin Kim, Jun Hee Sui, Sung Kyu Lee, Dong shick Chin, Sung Nok Hong
Clin Exp Pediatr. 1982;25(3):225-233.   Published online March 31, 1982
Tetralogy of Fallot is one of the most common cyanotic congenital heart disease. It consists of four features anatomically pulmonic stenosis or atresia, ventricular septal defect, overriding aorta, and right ventricular hypertrophy. One hundred and ninety one cases of Tetralogy of Fallot were confirmed by cardiaccatheterization at Severance Hospital. These were observed on general feature, cardiac catheterization findings and outcome...
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