Evidence map›Paper›PMID 39680069›Full record

ArticlePediatric cardiology2026

Association Between Location of Pulmonary Outflow Obstruction and Right Ventricular Size and Function After Repair of Tetralogy of Fallot, Pulmonary Atresia, and Major Aortopulmonary Collaterals.

Andrew Brennan, Rajesh Punn, Leo Lopez, Zsofia Long, Doff B McElhinney, Richard D Mainwaring, Michael Ma, Mark K Friedberg, Frank L Hanley, Alisa A Arunamata

Abstract read
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Article in Pediatric cardiology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Andrew BrennanDivision of Pediatric Cardiology, Department of Pediatrics, Stanford University School of Medicine, 750 Welch Road, Suite 305, Palo Alto, CA, 94304, USA. ambrenn@stanford.edu.
Rajesh PunnDivision of Pediatric Cardiology, Department of Pediatrics, Stanford University School of Medicine, 750 Welch Road, Suite 305, Palo Alto, CA, 94304, USA.
Leo LopezDivision of Pediatric Cardiology, Department of Pediatrics, Stanford University School of Medicine, 750 Welch Road, Suite 305, Palo Alto, CA, 94304, USA.
Zsofia LongDivision of Pediatric Cardiology, Department of Pediatrics, Stanford University School of Medicine, 750 Welch Road, Suite 305, Palo Alto, CA, 94304, USA.
Doff B McElhinneyDivision of Pediatric Cardiology, Department of Pediatrics, Stanford University School of Medicine, 750 Welch Road, Suite 305, Palo Alto, CA, 94304, USA.
Richard D MainwaringDepartment of Cardiothoracic Surgery, Stanford University School of Medicine, Palo Alto, CA, USA.
Michael MaDepartment of Cardiothoracic Surgery, Stanford University School of Medicine, Palo Alto, CA, USA.
Mark K FriedbergLabatt Family Heart Center, Department of Pediatrics, Hospital for Sick Children, Toronto, ON, Canada.
Frank L HanleyDepartment of Cardiothoracic Surgery, Stanford University School of Medicine, Palo Alto, CA, USA.
Alisa A ArunamataDivision of Pediatric Cardiology, Department of Pediatrics, Stanford University School of Medicine, 750 Welch Road, Suite 305, Palo Alto, CA, 94304, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Quantification of right ventricular (RV) size and function after tetralogy of Fallot repair is critical for determining timing of reintervention and outcomes. Tetralogy of Fallot patients with pulmonary atresia and major aortopulmonary collateral arteries (TOF/PA/MAPCAs) are a unique group in which the RV is subjected to various loading conditions, allowing for direct comparison. Retrospective evaluation of RV echocardiographic indices in repaired pediatric TOF/PA/MAPCAs patients (2/2002 - 4/2018). Patients were categorized as having conduit stenosis (peak gradient ≥ 2.5 m/s) and/or distal pulmonary artery (PA) stenoses (requiring catheter or surgical intervention and > 1/2 systemic RV pressures). A comparison group (N = 9) included distinct age-matched repaired patients without residual lesions. Indexed right heart dimensions were larger in patients with distal PA stenoses (N = 49) compared to conduit stenosis (N = 26), including RV end-diastolic and end-systolic dimensions (p < 0.01), despite earlier time to reintervention (p < 0.0001). RV fractional area change (FAC) was diminished in patients with distal PA stenoses compared to patients without residual lesions (p = 0.006). Patients with conduit stenosis demonstrated a marked decrement in tricuspid annular plane systolic excursion (TAPSE) z-scores. Repaired TOF/PA/MAPCAs patients with residual distal PA stenoses have larger right heart dimensions compared to patients with conduit stenosis, and decreased RV FAC compared to patients without residual lesions at 1-2 years after repair, suggesting early surveillance and immediate intervention on stenotic PA segments appears warranted to decrease the risk of further deterioration of RV systolic function.

Indexed as

Cardiac Surgical ProceduresHeart VentriclesPulmonary ArteryPulmonary AtresiaTetralogy of FallotVentricular Function, RightChildChild, PreschoolCollateral CirculationEchocardiographyFemaleHumansInfantMaleRetrospective StudiesEchocardiogramLongitudinal strainMajor aortopulmonary collateral arteriesRight ventricleTetralogy of fallot

Identifiers

PMID39680069

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.