{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,13]],"date-time":"2026-08-13T20:39:02Z","timestamp":1786653542619,"version":"build-2736575974"},"reference-count":24,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"3","license":[{"start":{"date-parts":[[2025,5,1]],"date-time":"2025-05-01T00:00:00Z","timestamp":1746057600000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-sa\/4.0"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2025,5]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Tetralogy of Fallot\u00a0(TOF) repair using a transannular patch\u00a0(TAP) may lead to varying degrees of pulmonary insufficiency\u00a0(PI) due to loss of pulmonary valve integrity. The subsequent right ventricle\u00a0(RV) dilatation and dysfunction over time may directly or indirectly affect exercise capacity.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>\n                      Fifty-six patients who had undergone intracardiac repair of TOF between January 2010 and December 2015 were subjected to exercise stress testing. Twenty-six patients underwent TAP placement, and 30\u00a0patients did not. The modified BRUCE protocol was used on a standard cycle ergometer for exercise testing. The total duration of exercise, the heart rate achieved at the peak of exercise, the heart rate reserve, and the maximal oxygen consumption\u00a0(VO\n                      <jats:sub>2<\/jats:sub>\n                      \u00a0max) in patients in the TAP repair group were compared to those in the non-TAP group.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Patients with a TAP had significantly lower exercise capacity compared to those without TAP. Both the total duration of exercise, the heart rate achieved at the peak of exercise, the heart rate reserve, and the VO\n                      <jats:sup>2<\/jats:sup>\n                      \u00a0max were higher in patients in the TAP repair group compared to the non-TAP group. The VO\n                      <jats:sup>2<\/jats:sup>\n                      \u00a0max in the non-TAP group was higher\u00a0(37.47\u00a0\u00b1\u00a05.7\u00a0ml\/kg\/min) than that of the TAP group\u00a0(30.5\u00a0\u00b1\u00a05.0\u00a0ml\/kg\/min)\u00a0(\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u00a0=\u00a00.02). Multivariate analysis showed that neither TAP nor PI was predictive of exercise capacity. However, we found that RV function and overall health status were significant predictors of exercise capacity.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>\n                      The non-TAP group had a better VO\n                      <jats:sup>2\u00a0<\/jats:sup>\n                      max, heart rate recovery time, and heart rate reserve than the TAP group at 5\u00a0years of follow-up.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.4103\/apc.apc_16_25","type":"journal-article","created":{"date-parts":[[2025,10,7]],"date-time":"2025-10-07T17:02:09Z","timestamp":1759856529000},"page":"210-216","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":1,"title":["Exercise capacity among patients with tetralogy of Fallot who underwent transannular and non-transannular repair"],"prefix":"10.4103","volume":"18","author":[{"given":"Sachin","family":"Talwar","sequence":"first","affiliation":[{"name":"Department of Cardiothoracic and Vascular Surgery, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gaind","family":"Saurabh","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic and Vascular Surgery, All India Institute of Medical Sciences, Raipur, Chhattisgarh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sachin","family":"Bhushan","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic and Vascular Surgery, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vishal Vinayak","family":"Bhende","sequence":"additional","affiliation":[{"name":"Bhanubhai and Madhuben Patel Cardiac Centre, Shree Krishna Hospital, Bhaikaka University, Karamsad, Gujarat, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vishwa Prakash","family":"Gupta","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic and Vascular Surgery, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2025,10,7]]},"reference":[{"key":"R1-20260420","doi-asserted-by":"crossref","first-page":"510","DOI":"10.1136\/heart.88.5.510","article-title":"Influence of the pulmonary annulus diameter on pulmonary regurgitation and right ventricular pressure load after repair of tetralogy of Fallot","volume":"88","author":"Uebing","year":"2002","journal-title":"Heart"},{"key":"R2-20260420","doi-asserted-by":"crossref","first-page":"1431","DOI":"10.1016\/j.athoracsur.2005.04.016","article-title":"Tetralogy of fallot: Results of a pulmonary valve-sparing strategy","volume":"80","author":"Stewart","year":"2005","journal-title":"Ann Thorac Surg"},{"key":"R3-20260420","doi-asserted-by":"crossref","first-page":"483","DOI":"10.1093\/ejcts\/ezs372","article-title":"Tetralogy of fallot repair: Optimal z-score use for transannular patch insertion","volume":"43","author":"Awori","year":"2013","journal-title":"Eur J Cardiothorac Surg"},{"key":"R4-20260420","doi-asserted-by":"crossref","first-page":"208","DOI":"10.1055\/s-2007-1023386","article-title":"Risk factors for early and late failure after repair of tetralogy of fallot, and their neutralization","volume":"32","author":"Kirklin","year":"1984","journal-title":"Thorac Cardiovasc Surg"},{"key":"R5-20260420","doi-asserted-by":"crossref","first-page":"783","DOI":"10.1016\/0003-4975(89)90671-1","article-title":"Effect of transannular patching on outcome after repair of tetralogy of fallot","volume":"48","author":"Kirklin","year":"1989","journal-title":"Ann Thorac Surg"},{"key":"R6-20260420","doi-asserted-by":"crossref","first-page":"1068","DOI":"10.1016\/j.jacc.2003.10.045","article-title":"Factors associated with impaired clinical status in long-term survivors of tetralogy of fallot repair evaluated by magnetic resonance imaging","volume":"43","author":"Geva","year":"2004","journal-title":"J Am Coll Cardiol"},{"key":"R7-20260420","doi-asserted-by":"crossref","first-page":"63","DOI":"10.1007\/s11886-002-0128-z","article-title":"Management of pulmonary regurgitation after tetralogy of fallot repair","volume":"4","author":"Graham","year":"2002","journal-title":"Curr Cardiol Rep"},{"key":"R8-20260420","doi-asserted-by":"crossref","first-page":"204","DOI":"10.1016\/S0022-5223(19)38815-4","article-title":"Surgical repair of tetralogy of fallot. 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