Remplacement de valve pulmonaire chez les enfants avec tétralogie de Fallot réparée


Frédéric Dallaire

Centre de recherche clinique Étienne-Le Bel du CHUS


Domaine : santé circulatoire et respiratoire

Programme chercheurs-boursiers cliniciens - Junior 1

Concours 2015-2016

Tetralogy of Fallot is a severe heart malformation. It is surgically repaired within the first year of life but the surgery often leaves one of the four heart valves severely leaking. This leak is well tolerated for many years but it may lead to cardiac complications later in childhood. It is possible to replace this valve with an intervention called "pulmonary valve replacement". However, this valve replacement is not without risks. In children, the risks of leaving the leaking valve in place compared to the risks of replacing the valve are not clear. Consequently, it is difficult to determine which patients would benefit the most from a replacement of the valve, and which patients would be better off with their leaking valve in place.

The objective of my research is to find clues that will allow us to identify those patients who are most affected by their leaking valve in order to better target those who would benefit from valve replacement and, consequently, those who could be spared this unnecessary surgery.

We aim to answer the following questions:

  • Are there medical tests that could predict an increased risk of complications (hospitalization, mortality, etc.)?
  • Does a replacement of the valve decrease the risk of these complications?
  • Is there a link between exercise intolerance and quality of life in these patients?

To do this, we will create a patient registry of all patients with tetralogy of Fallot treated in Québec. The registry will contain information on symptoms, medical test results, exercise capacity, and on all healthcare service encounters.

Our overarching goal is to improve the patients' quality of life by performing valve replacement only on children who would truly benefit from the intervention.