{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T11:51:47Z","timestamp":1753876307770,"version":"3.41.2"},"reference-count":11,"publisher":"Oxford University Press (OUP)","issue":"12","license":[{"start":{"date-parts":[[2021,11,30]],"date-time":"2021-11-30T00:00:00Z","timestamp":1638230400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,12,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Although the life expectancy of patients with tetralogy of Fallot (TOF) is comparable to that of the general population due to advancements in surgical intervention, if untreated, patients with TOF may die during their childhood. However, it has been anecdotally reported that a small number of patients with unrepaired TOF survived into their senescence.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Case summary<\/jats:title>\n                  <jats:p>A 71-year-old man with a history of multiple heart failure admissions was referred to our institute after successful cardiopulmonary arrest resuscitation. Transthoracic echocardiography showed the overriding of the aorta on a large ventricular septal defect and right ventricular hypertrophy, along with severe pulmonary stenosis (PS), all of which indicated unrepaired TOF. Computed tomography revealed a patent Blalock\u2013Taussig shunt, which was constructed at the age of 19 years. Coronary angiography revealed multivessel coronary stenoses. Although radical intracardiac repair was not performed due to his multiple comorbidities, his heart failure symptoms were significantly improved owing to proper medication titration. One year following discharge, the patient was well and enjoyed playing golf.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Discussion<\/jats:title>\n                  <jats:p>Specific anatomical, functional, and haemodynamic characteristics may be required for the long-term survival of patients with TOF. Pulmonary stenosis should be initially mild to guarantee pulmonary flow during childhood and adolescence, and gradual PS exacerbation should be paralleled with systemic-to-pulmonary collateral development or an extracardiac shunt. Moreover, reduced left ventricular compliance may act as a balancing factor against a right-to-left shunt. The presence of all of these special requirements may have contributed to the unusual survival for this patient.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ehjcr\/ytab486","type":"journal-article","created":{"date-parts":[[2021,12,1]],"date-time":"2021-12-01T14:46:29Z","timestamp":1638369989000},"source":"Crossref","is-referenced-by-count":0,"title":["\u2018Superimposed miracles\u2019: an extremely rare case of a septuagenarian with an unrepaired tetralogy of Fallot: a case report"],"prefix":"10.1093","volume":"5","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2503-2108","authenticated-orcid":false,"given":"Makiko","family":"Suzuki","sequence":"first","affiliation":[{"name":"Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe, Hyogo 650-0017, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6764-6293","authenticated-orcid":false,"given":"Kensuke","family":"Matsumoto","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe, Hyogo 650-0017, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2688-3468","authenticated-orcid":false,"given":"Yu","family":"Izawa","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe, Hyogo 650-0017, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ken-Ichi","family":"Hirata","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe, Hyogo 650-0017, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2021,11,30]]},"reference":[{"key":"2021122913225933900_ytab486-B1","doi-asserted-by":"crossref","first-page":"230","DOI":"10.1053\/j.semperi.2015.03.007","article-title":"Detection of critical congenital heart defects: review of contributions from prenatal and newborn screening","volume":"39","author":"Olney","year":"2015","journal-title":"Semin Perinatol"},{"key":"2021122913225933900_ytab486-B2","doi-asserted-by":"crossref","first-page":"458","DOI":"10.1016\/0002-9149(78)90941-4","article-title":"Life expectancy without surgery in tetralogy of Fallot","volume":"42","author":"Bertranou","year":"1978","journal-title":"Am J Cardiol"},{"key":"2021122913225933900_ytab486-B3","doi-asserted-by":"crossref","first-page":"38","DOI":"10.1111\/j.1076-7460.2007.05425.x","article-title":"Uncorrected tetralogy of Fallot in an 86-year-old patient","volume":"16","author":"Alonso","year":"2007","journal-title":"Am J Geriatr Cardiol"},{"key":"2021122913225933900_ytab486-B4","doi-asserted-by":"crossref","first-page":"E78","DOI":"10.1111\/j.1747-0803.2012.00642.x","article-title":"Unrepaired tetralogy of fallot in an 85-year-old man","volume":"7","author":"Gorla","year":"2012","journal-title":"Congenit Heart Dis"},{"key":"2021122913225933900_ytab486-B5","doi-asserted-by":"crossref","first-page":"631","DOI":"10.1111\/j.0742-2822.2004.03160.x","article-title":"Survival to the age of 52 years in a man with unrepaired tetralogy of Fallot","volume":"21","author":"Makaryus","year":"2004","journal-title":"Echocardiography"},{"key":"2021122913225933900_ytab486-B6","doi-asserted-by":"crossref","first-page":"361","DOI":"10.1136\/pgmj.63.739.361","article-title":"Cyanotic tetralogy of Fallot in a 77 year old man","volume":"63","author":"Thomas","year":"1987","journal-title":"Postgrad Med J"},{"key":"2021122913225933900_ytab486-B7","doi-asserted-by":"crossref","first-page":"133","DOI":"10.1136\/pgmj.2004.020172","article-title":"Unoperated tetralogy of Fallot: case report of a natural survivor who died in his 73rd year; is it ever too late to operate?","volume":"81","author":"Yang","year":"2005","journal-title":"Postgrad Med J"},{"key":"2021122913225933900_ytab486-B8","doi-asserted-by":"crossref","first-page":"1462","DOI":"10.1016\/S0140-6736(09)60657-7","article-title":"Tetralogy of Fallot","volume":"374","author":"Apitz","year":"2009","journal-title":"Lancet"},{"key":"2021122913225933900_ytab486-B9","doi-asserted-by":"crossref","first-page":"593","DOI":"10.1056\/NEJM199308263290901","article-title":"Long-term outcome in patients undergoing surgical repair of tetralogy of Fallot","volume":"329","author":"Murphy","year":"1993","journal-title":"N Engl J Med"},{"key":"2021122913225933900_ytab486-B10","doi-asserted-by":"crossref","first-page":"131","DOI":"10.1007\/BF02552393","article-title":"Congenital extracardiac shunts with tetralogy of Fallot","volume":"4","author":"Liberthson","year":"1981","journal-title":"Cardiovasc Intervent Radiol"},{"key":"2021122913225933900_ytab486-B11","doi-asserted-by":"crossref","first-page":"124","DOI":"10.1161\/01.CIR.56.1.124","article-title":"Pulmonary vascular disease complicating the Blalock-Taussig anastomosis","volume":"56","author":"Hofschire","year":"1977","journal-title":"Circulation"}],"container-title":["European Heart Journal - Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/ehjcr\/advance-article-pdf\/doi\/10.1093\/ehjcr\/ytab486\/41390016\/ytab486.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ehjcr\/article-pdf\/5\/12\/ytab486\/41970973\/ytab486.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ehjcr\/article-pdf\/5\/12\/ytab486\/41970973\/ytab486.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,12,29]],"date-time":"2021-12-29T13:25:15Z","timestamp":1640784315000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/ehjcr\/article\/doi\/10.1093\/ehjcr\/ytab486\/6446511"}},"subtitle":[],"editor":[{"given":"Mohammed","family":"Al-Hijji","sequence":"additional","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]},{"given":"Brett Sydney","family":"Bernstein","sequence":"additional","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]},{"given":"Mariame","family":"Chakir","sequence":"additional","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]},{"given":"Flemming Javier","family":"Olsen","sequence":"additional","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]}],"short-title":[],"issued":{"date-parts":[[2021,11,30]]},"references-count":11,"journal-issue":{"issue":"12","published-print":{"date-parts":[[2021,12,3]]}},"URL":"https:\/\/doi.org\/10.1093\/ehjcr\/ytab486","relation":{},"ISSN":["2514-2119"],"issn-type":[{"type":"electronic","value":"2514-2119"}],"subject":[],"published-other":{"date-parts":[[2021,12,1]]},"published":{"date-parts":[[2021,11,30]]},"article-number":"ytab486"}}