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Bhagra CJ, Hickey EJ, Van De Bruaene A, Roche SL, Horlick EM, Wald RM. Pulmonary valve procedures late after repair of tetralogy of Fallot: Current perspectives and contemporary approaches to management. <i>Can J Cardiol<\/i> 2017; 33: 1138\u20131149.","DOI":"10.1016\/j.cjca.2017.06.011"},{"key":"2","doi-asserted-by":"crossref","unstructured":"2. Baumgartner H, Bonhoeffer P, De Groot NM, de Haan F, Deanfield JE, Galie N, et al. ESC guidelines for the management of grown-up congenital heart disease (new version 2010). <i>Eur Heart J<\/i> 2010; 31: 2915\u20132957.","DOI":"10.1016\/j.repce.2012.05.004"},{"key":"3","doi-asserted-by":"crossref","unstructured":"3. Ferraz Cavalcanti PE, Sa MP, Santos CA, Esmeraldo IM, de Escobar RR, de Menezes AM, et al. Pulmonary valve replacement after operative repair of tetralogy of Fallot: Meta-analysis and meta-regression of 3,118 patients from 48 studies. <i>J Am Coll Cardiol<\/i> 2013; 62: 2227\u20132243.","DOI":"10.1016\/j.jacc.2013.04.107"},{"key":"4","doi-asserted-by":"crossref","unstructured":"4. Geva T. Indications and timing of pulmonary valve replacement after tetralogy of Fallot repair. <i>Semin Thorac Cardiovasc Surg Pediatr Card Surg Annu<\/i> 2006: 11\u201322.","DOI":"10.1053\/j.pcsu.2006.02.009"},{"key":"5","doi-asserted-by":"crossref","unstructured":"5. Buechel ER, Dave HH, Kellenberger CJ, Dodge-Khatami A, Pretre R, Berger F, et al. Remodelling of the right ventricle after early pulmonary valve replacement in children with repaired tetralogy of Fallot: Assessment by cardiovascular magnetic resonance. <i>Eur Heart J<\/i> 2005; 26: 2721\u20132727.","DOI":"10.1093\/eurheartj\/ehi581"},{"key":"6","doi-asserted-by":"crossref","unstructured":"6. Oosterhof T, van Straten A, Vliegen HW, Meijboom FJ, van Dijk AP, Spijkerboer AM, et al. Preoperative thresholds for pulmonary valve replacement in patients with corrected tetralogy of Fallot using cardiovascular magnetic resonance. <i>Circulation<\/i> 2007; 116: 545\u2013551.","DOI":"10.1161\/CIRCULATIONAHA.106.659664"},{"key":"7","doi-asserted-by":"crossref","unstructured":"7. Geva T. Repaired tetralogy of Fallot: The roles of cardiovascular magnetic resonance in evaluating pathophysiology and for pulmonary valve replacement decision support. <i>J Cardiovasc Magn Reson<\/i> 2011; 13: 9.","DOI":"10.1186\/1532-429X-13-9"},{"key":"8","doi-asserted-by":"crossref","unstructured":"8. Tatewaki H, Shiose A. Pulmonary valve replacement after repaired tetralogy of Fallot. <i>Gen Thorac Cardiovasc Surg<\/i> 2018; 66: 509\u2013515.","DOI":"10.1007\/s11748-018-0931-0"},{"key":"9","unstructured":"9. Albouaini K, Egred M, Alahmar A, Wright DJ. Cardiopulmonary exercise testing and its application. <i>Heart<\/i> 2007; 93: 1285\u20131292."},{"key":"10","doi-asserted-by":"crossref","unstructured":"10. Takken T, Blank AC, Hulzebos EH, van Brussel M, Groen WG, Helders PJ. Cardiopulmonary exercise testing in congenital heart disease: (Contra)indications and interpretation. <i>Neth Heart J<\/i> 2009; 17: 385\u2013392.","DOI":"10.1007\/BF03086289"},{"key":"11","doi-asserted-by":"crossref","unstructured":"11. Baba R, Nagashima M, Goto M, Nagano Y, Yokota M, Tauchi N, et al. Oxygen uptake efficiency slope: A new index of cardiorespiratory functional reserve derived from the relation between oxygen uptake and minute ventilation during incremental exercise. <i>J Am Coll Cardiol<\/i> 1996; 28: 1567\u20131572.","DOI":"10.1016\/S0735-1097(96)00412-3"},{"key":"12","doi-asserted-by":"crossref","unstructured":"12. Buechel EV, Kaiser T, Jackson C, Schmitz A, Kellenberger CJ. Normal right- and left ventricular volumes and myocardial mass in children measured by steady state free precession cardiovascular magnetic resonance. <i>J Cardiovasc Magn Reson<\/i> 2009; 11: 19.","DOI":"10.1186\/1532-429X-11-19"},{"key":"13","doi-asserted-by":"crossref","unstructured":"13. Kipps AK, Powell AJ, Levine JC. Muscular infundibular atresia is associated with coronary ostial atresia in pulmonary atresia with intact ventricular septum. <i>Congenit Heart Dis<\/i> 2011; 6: 444\u2013450.","DOI":"10.1111\/j.1747-0803.2011.00541.x"},{"key":"14","doi-asserted-by":"crossref","unstructured":"14. Leonardi B, Gentili F, Perrone MA, Sollazzo F, Cocomello L, Silva Kikina S, et al. Cardiopulmonary exercise testing in repaired tetralogy of Fallot: Multiparametric overview and correlation with cardiac magnetic resonance and physical activity level. <i>J Cardiovasc Dev Dis<\/i> 2022; 9: 26.","DOI":"10.3390\/jcdd9010026"},{"key":"15","doi-asserted-by":"crossref","unstructured":"15. Ho JG, Schamberger MS, Hurwitz RA, Johnson TR, Sterrett LE, Ebenroth ES. The effects of pulmonary valve replacement for severe pulmonary regurgitation on exercise capacity and cardiac function. <i>Pediatr Cardiol<\/i> 2015; 36: 1194\u20131203.","DOI":"10.1007\/s00246-015-1143-3"},{"key":"16","doi-asserted-by":"crossref","unstructured":"16. Kawamura J, Yasukochi S, Takigiku K, Takei K, Saikawa Y, Nishiyama T, et al. Quantification of pulmonary regurgitation after surgical repair of tetralogy of Fallot using vector flow mapping. <i>Circ J<\/i> 2025; 89: 1510\u20131518.","DOI":"10.1253\/circj.CJ-24-0273"},{"key":"17","doi-asserted-by":"crossref","unstructured":"17. Roest AA, Helbing WA, Kunz P, van den Aardweg JG, Lamb HJ, Vliegen HW, et al. Exercise MR imaging in the assessment of pulmonary regurgitation and biventricular function in patients after tetralogy of fallot repair. <i>Radiology<\/i> 2002; 223: 204\u2013211.","DOI":"10.1148\/radiol.2231010924"},{"key":"18","doi-asserted-by":"crossref","unstructured":"18. O\u2019Meagher S, Munoz PA, Alison JA, Young IH, Tanous DJ, Celermajer DS, et al. Exercise capacity and stroke volume are preserved late after tetralogy repair, despite severe right ventricular dilatation. <i>Heart<\/i> 2012; 98: 1595\u20131599.","DOI":"10.1136\/heartjnl-2012-302147"},{"key":"19","doi-asserted-by":"crossref","unstructured":"19. Meadows J, Powell AJ, Geva T, Dorfman A, Gauvreau K, Rhodes J. Cardiac magnetic resonance imaging correlates of exercise capacity in patients with surgically repaired tetralogy of Fallot. <i>Am J Cardiol<\/i> 2007; 100: 1446\u20131450.","DOI":"10.1016\/j.amjcard.2007.06.038"},{"key":"20","doi-asserted-by":"crossref","unstructured":"20. Menon SC, Kaza AK, Puchalski MD. Effect of ventricular size and function on exercise performance and the electrocardiogram in repaired tetralogy of Fallot with pure pulmonary regurgitation. <i>Ann Pediatr Cardiol<\/i> 2012; 5: 151\u2013155.","DOI":"10.4103\/0974-2069.99617"},{"key":"21","doi-asserted-by":"crossref","unstructured":"21. Barmeyer A, Mullerleile K, Mortensen K, Meinertz T. Diastolic dysfunction in exercise and its role for exercise capacity. <i>Heart Fail Rev<\/i> 2009; 14: 125\u2013134.","DOI":"10.1007\/s10741-008-9105-y"},{"key":"22","doi-asserted-by":"crossref","unstructured":"22. Redington AN. Determinants and assessment of pulmonary regurgitation in tetralogy of Fallot: Practice and pitfalls. <i>Cardiol Clin<\/i> 2006; 24: 631\u2013639, vii.","DOI":"10.1016\/j.ccl.2006.08.007"},{"key":"23","doi-asserted-by":"crossref","unstructured":"23. Takahashi T, Saiki H, Sato A, Kuwata S, Nakano S, Sato Y, et al. Significance of end-diastolic forward flow in patients with repaired tetralogy of Fallot: Its interaction with the left ventricular property and end organ damage. <i>Circ J<\/i> 2023; 88: 73\u201380.","DOI":"10.1253\/circj.CJ-23-0147"},{"key":"24","doi-asserted-by":"crossref","unstructured":"24. Samyn MM, Kwon EN, Gorentz JS, Yan K, Danduran MJ, Cava JR, et al. Restrictive versus nonrestrictive physiology following repair of tetralogy of Fallot: Is there a difference? <i>J Am Soc Echocardiogr<\/i> 2013; 26: 746\u2013755.","DOI":"10.1016\/j.echo.2013.03.019"},{"key":"25","doi-asserted-by":"crossref","unstructured":"25. Takahashi K. Usefulness of end-diastolic forward flow in patients with repaired tetralogy of Fallot. <i>Circ J<\/i> 2023; 88: 81\u201382.","DOI":"10.1253\/circj.CJ-23-0754"},{"key":"26","doi-asserted-by":"crossref","unstructured":"26. Alborikan S, Pandya B, Von Klemperer K, Walker F, Cullen S, Badiani S, et al. Cardiopulmonary exercise test (CPET) in patients with repaired tetralogy of Fallot (rTOF); A systemic review. <i>Int J Cardiol Congenit Heart Dis<\/i> 2020; 1: 100050.","DOI":"10.1016\/j.ijcchd.2020.100050"},{"key":"27","doi-asserted-by":"crossref","unstructured":"27. Kim SJ, Li MH, Noh CI, Kim SH, Lee CH, Yoon JK. Impact of pulmonary arterial elastance on right ventricular mechanics and exercise capacity in repaired tetralogy of Fallot. <i>Korean Circ J<\/i> 2023; 53: 406\u2013417.","DOI":"10.4070\/kcj.2022.0228"},{"key":"28","doi-asserted-by":"crossref","unstructured":"28. Egbe AC, Kothapalli S, Miranda WR, Pislaru S, Ammash NM, Borlaug BA, et al. Assessment of right ventricular\u2013pulmonary arterial coupling in chronic pulmonary regurgitation. <i>Can J Cardiol<\/i> 2019; 35: 914\u2013922.","DOI":"10.1016\/j.cjca.2019.03.009"},{"key":"29","doi-asserted-by":"crossref","unstructured":"29. Egbe AC, Anavekar NS, Connolly HM. Abnormal pulmonary arterial elastance is associated with reduced exercise capacity in tetralogy of Fallot. <i>J Am Heart Assoc<\/i> 2019; 8: e011731.","DOI":"10.1161\/JAHA.118.011731"},{"key":"30","doi-asserted-by":"crossref","unstructured":"30. van Huysduynen BH, van Straten A, Swenne CA, Maan AC, van Eck HJ, Schalij MJ, et al. Reduction of QRS duration after pulmonary valve replacement in adult Fallot patients is related to reduction of right ventricular volume. <i>Eur Heart J<\/i> 2005; 26: 928\u2013932.","DOI":"10.1093\/eurheartj\/ehi140"},{"key":"31","doi-asserted-by":"crossref","unstructured":"31. Discigil B, Dearani JA, Puga FJ, Schaff HV, Hagler DJ, Warnes CA, et al. Late pulmonary valve replacement after repair of tetralogy of Fallot. <i>J Thorac Cardiovasc Surg<\/i> 2001; 121: 344\u2013351.","DOI":"10.1067\/mtc.2001.111209"},{"key":"32","doi-asserted-by":"crossref","unstructured":"32. Therrien J, Siu SC, McLaughlin PR, Liu PP, Williams WG, Webb GD. Pulmonary valve replacement in adults late after repair of tetralogy of fallot: Are we operating too late? <i>J Am Coll Cardiol<\/i> 2000; 36: 1670\u20131675.","DOI":"10.1016\/S0735-1097(00)00930-X"},{"key":"33","doi-asserted-by":"crossref","unstructured":"33. Lim C, Lee JY, Kim WH, Kim SC, Song JY, Kim SJ, et al. Early replacement of pulmonary valve after repair of tetralogy: Is it really beneficial? <i>Eur J Cardiothorac Surg<\/i> 2004; 25: 728\u2013734.","DOI":"10.1016\/j.ejcts.2004.01.036"},{"key":"34","doi-asserted-by":"crossref","unstructured":"34. Geva T. Indications for pulmonary valve replacement in repaired tetralogy of Fallot: The quest continues. <i>Circulation<\/i> 2013; 128: 1855\u20131857.","DOI":"10.1161\/CIRCULATIONAHA.113.005878"},{"key":"35","doi-asserted-by":"crossref","unstructured":"35. Therrien J, Provost Y, Merchant N, Williams W, Colman J, Webb G. Optimal timing for pulmonary valve replacement in adults after tetralogy of Fallot repair. <i>Am J Cardiol<\/i> 2005; 95: 779\u2013782.","DOI":"10.1016\/j.amjcard.2004.11.037"},{"key":"36","doi-asserted-by":"crossref","unstructured":"36. Van den Eynde J, Sa M, Vervoort D, Roever L, Meyns B, Budts W, et al. Pulmonary valve replacement in tetralogy of Fallot: An updated meta-analysis. <i>Ann Thorac Surg<\/i> 2022; 113: 1036\u20131046.","DOI":"10.1016\/j.athoracsur.2020.11.040"},{"key":"37","doi-asserted-by":"crossref","unstructured":"37. Frigiola A, Tsang V, Bull C, Coats L, Khambadkone S, Derrick G, et al. Biventricular response after pulmonary valve replacement for right ventricular outflow tract dysfunction: Is age a predictor of outcome? <i>Circulation<\/i> 2008; 118(Suppl): S182\u2013S190.","DOI":"10.1161\/CIRCULATIONAHA.107.756825"},{"key":"38","doi-asserted-by":"crossref","unstructured":"38. Ghez O, Tsang VT, Frigiola A, Coats L, Taylor A, Van Doorn C, et al. Right ventricular outflow tract reconstruction for pulmonary regurgitation after repair of tetralogy of Fallot. Preliminary results. <i>Eur J Cardiothorac Surg<\/i> 2007; 31: 654\u2013658.","DOI":"10.1016\/j.ejcts.2006.12.031"},{"key":"39","doi-asserted-by":"crossref","unstructured":"39. Gauthier N, Muter A, Rhodes J, Gauvreau K, Nathan M. Better preoperative exercise function is associated with shorter hospital stay after paediatric pulmonary valve replacement or conduit revision. <i>Cardiol Young<\/i> 2021; 31: 1636\u20131643.","DOI":"10.1017\/S1047951121000743"},{"key":"40","doi-asserted-by":"crossref","unstructured":"40. Heng EL, Gatzoulis MA, Uebing A, Sethia B, Uemura H, Smith GC, et al. Immediate and midterm cardiac remodeling after surgical pulmonary valve replacement in adults with repaired tetralogy of Fallot: A prospective cardiovascular magnetic resonance and clinical study. <i>Circulation<\/i> 2017; 136: 1703\u20131713.","DOI":"10.1161\/CIRCULATIONAHA.117.027402"},{"key":"41","doi-asserted-by":"crossref","unstructured":"41. Gengsakul A, Harris L, Bradley TJ, Webb GD, Williams WG, Siu SC, et al. The impact of pulmonary valve replacement after tetralogy of Fallot repair: A matched comparison. <i>Eur J Cardiothorac Surg<\/i> 2007; 32: 462\u2013468.","DOI":"10.1016\/j.ejcts.2007.06.009"},{"key":"42","doi-asserted-by":"crossref","unstructured":"42. LoMauro A, Aliverti A. Sex differences in respiratory function. <i>Breathe (Sheff)<\/i> 2018; 14: 131\u2013140.","DOI":"10.1183\/20734735.000318"},{"key":"43","doi-asserted-by":"crossref","unstructured":"43. Kaczor JJ, Ziolkowski W, Popinigis J, Tarnopolsky MA. 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