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Tetralogy of FallotNCT00266188

Follow up of Post-repair Tetralogy of Fallot

An observational study of Tetralogy of Fallot, run by Competence Network for Congenital Heart Defects at 14 sites in Germany.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

Tetralogy of Fallot is the most frequent complex congenital heart malformation. Over the past five decades, surgical repair has been performed with respectable results. However, relevant postoperative residues frequently remain. Read more about this study

Who is it for?
Ages 8 years and older
Conditions the study is for
Tetralogy of Fallot
How many people
406 participants
Where
14 sitesGermany
Study dates
Jan 2005to Jun 2008
Phase
Observational
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 8 years and older
  • All sexes
  • No healthy volunteers
  • Child, Adult, Older adult

Study population: Patient with tetralogy of Fallot

Who may be able to join

  • Written consent of the patient and/or the patient's legal representative
  • Patients with tetralogy of Fallot (including pulmonary atresia with extreme form of VSD ) after corrective operation
  • The corrective intervention has to date back to at least one year before study inclusion
  • Ergospirometry and MRI examination can be carried out on an outpatient basis (i. e. patients are normally older than 8 years)
  • Patients are not selected according to functional status, i. e. in terms of potentially necessary reintervention measures (e. g. cardiac catheter intervention, pulmonary valve replacement)

Who cannot join

  • Lack of consent
  • Tetralogy of Fallot or pulmonary atresia with VSD without corrective operation (or corrective operation that dates back to less than one year before)
  • Pulmonary valve agenesia, DORV (if there is a distinct discontinuity between mitral valve and aortic valve)
  • Associated severe heart defects (e. g. AV canal)
  • Other clinically relevant diseases, such as malignant tumour or florid diseases (in the investigating physician's assessment)
  • Patient is not able to perform ergospirometry (bicycle/treadmill) or contraindication exists
Show all 9Show fewer
  • Absolute MRI contraindication, e.g. cardiac pacemaker
  • Pregnant and breast-feeding patients
  • Lack of cardiac catheter findings (or MRI) before initial operation -

Trial locations and contacts

14 sites in 1 country.

14 sites in 1 country

Germany14 sites
  • Universitätsklinikum RWTH Aachen

    Aachen, North Rhine-Westphalia, D-52057

  • Herz-und Diabeteszentrum Nordrhein-Westfalen

    Bad Oeynhausen, North Rhine-Westphalia, D-32545

  • Deutsches Herzzentrum Berlin

    Berlin, State of Berlin, D-13353

  • Universitätsklinikum Charité

    Berlin, State of Berlin, D-13353

  • Herzzentrum Duisburg

    Duisburg, North Rhine-Westphalia, D-47137

  • Universitätsklinikum Essen

    Essen, North Rhine-Westphalia, D-45122

  • Herzzentrum Hamburg, UKE

    Hamburg, Free and Hanseatic City of Hamburg, D-29246

  • Medizinische Hochschule Hannover

    Hanover, Lower Saxony, D-30625

  • Universitätsklinikum Schleswig-Holstein Campus Kiel

    Kiel, North Rhine-Westphalia, D-24105

  • Herzzentrum Leipzig

    Leipzig, Saxony, D-04289

  • Deutsches Herzzentrum Muenchen

    Munich, Bavaria, D-80636

  • Universitätsklinikum Muenster

    Münster, North Rhine-Westphalia, D-48149

  • Deutsches Kinderherzzentrum

    Sankt Augustin, North Rhine-Westphalia, D-53757

  • Universitätsklinikum Tübingen

    Tübingen, Baden-Wurttemberg, D-72076

Other trials in Germany

About this study

Official title: Non-invasive Imaging and Exercise Tolerance Tests in Post-repair Tetralogy of Fallot - Intervention and Course in Patients Over 8 Years Old

Tetralogy of Fallot is the most frequent complex congenital heart malformation. Over the past five decades, surgical repair has been performed with respectable results. However, relevant postoperative residues frequently remain. Pulmonary insufficiency, in particular, has been identified as a factor limiting the right ventricular function and, accordingly, the quality of life and life expectancy.

With increasing use of cardiac MRI for both measurement of ventricular function and imaging of pulmonary arteries, residual defects have been discovered that were not detectable by echocardiography. There is mounting evidence of right ventricular pressure and volume stress in Fallot patients after surgical correction. At present, it is impossible to detect right ventricular insufficiency at an early stage. Hence, it is to be assumed that right ventricular insufficiency is underdiagnosed and therapeutic action frequently is initiated beyond the point of no return of ventricular function.

The objective of this study is the systematic collection of cross-sectional and longitudinal data from extensive standardised examinations, including MRI, echocardiography, pulmonary function and ergometry tests, ECG and quality of life assessments, in a large number of patients with surgically corrected tetralogy of Fallot, and the setup of a database. The data obtained are supposed to provide information on the long-term outcome of surgical correction, to help establish criteria for necessity and time of re-intervention or re-operation, and to assess the effectiveness of re-interventions and re-operations.

Read the detailed description

In the repair of tetralogy of Fallot, pulmonary insufficiency used to be tacitly accepted as a result of extensive transannular patching (TAP) and considered unobjectionable. In fact, this is well tolerated during the first postoperative years, but today there is increasing evidence that the resulting chronic volume stress to the right ventricle is harmful on the long run, in particular if there are stenoses of the pulmonary artery in addition. Such stenoses, partly due to distortions after shunt surgery, together with pulmonary insufficiency, lead to a combined volume and pressure load of the right ventricle. The chronic volume stress results in a decrease in biventricular function and exercise tolerance, associated with increasing electrical instability with frequent, mostly ventricular, dysrhythmias. This constellation brings about a significantly increased risk of cardiac death.

Pulmonary valve replacement can improve haemodynamics, exercise tolerance and dysrhythmia. However, it is still unclear, which criteria best indicate the need for re-operation or other re-intervention, such as balloon dilatations of peripheral pulmonary stenoses, and what may be the best point in time.

Cardiac MRI has been established as non-invasive method to quantify right and left ventricular function without radiation exposure. Correlating quantitative functional data to clinical conditions may permit the evaluation of factors that influence the long-term course after surgical repair of Fallot's tetralogy.

The objective of this study is to establish a broad database of cross-sectional and longitudinal (after one year) findings from extensive standardised examinations, including MRI, echocardiography, pulmonary function and ergometry tests, ECG, quality of life assessments performed and cardiac catheterisation, if indicated, on a large number of subjects with surgically corrected tetralogy of Fallot. The data obtained are supposed to determine parameters indicating beginning irreversibility of decreased cardiac function, to provide information on the long-term outcome of surgical correction, to help establish criteria for necessity and time of re-intervention or re-operation, and to assess the effectiveness of re-interventions and re-operations.

Keywords
Heart Defects, Congenital, Tetralogy of Fallot, Heart Septal Defects, Ventricular, Pulmonary Valve Diseases, Magnetic Resonance Imaging, Heart Catheterization, Echocardiography
Medical subject headings
Tetralogy of Fallot, Heart Defects, Congenital, Heart Septal Defects, Ventricular

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. - Assessment of the biventricular function via MRI, colour Doppler echocardiography, tissue Doppler and strain-rate imaging in correlation with objective exercise tolerance

  2. (spiroergometry)

  3. - Subjective quality of life

  4. - Prevalence of cardiac dysrhythmias

  5. - Mortality (above all in relapse interventions, such as interventional cardiac catheter or operation)

  6. - Morbidity (i. e. severe unwanted effects [SUE], particularly in relapse interventions, such as interventional cardiac catheter or operation)

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted16 Dec 2005 (estimated)
  2. Study startJan 2005
  3. Study completionJun 2008

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Observational
Observational model
Cohort
Time perspective
Prospective
Enrolment
406 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT00266188
Sponsor's protocol ID
MP 4.1
Other IDs
01G10210
Status last verified
Sep 2011
First submitted
15 Dec 2005
Last updated
21 Sep 2011
Results posted
No
Data monitoring committee
No

Publications

  • Sarikouch S, Koerperich H, Dubowy KO, Boethig D, Boettler P, Mir TS, Peters B, Kuehne T, Beerbaum P; German Competence Network for Congenital Heart Defects Investigators. Impact of gender and age on cardiovascular function late after repair of tetralogy of Fallot: percentiles based on cardiac magnetic resonance. Circ Cardiovasc Imaging. 2011 Nov;4(6):703-11. doi: 10.1161/CIRCIMAGING.111.963637. Epub 2011 Sep 9.

    PubMed 21908707
  • Mueller M, Rentzsch A, Hoetzer K, Raedle-Hurst T, Boettler P, Stiller B, Lemmer J, Sarikouch S, Beerbaum P, Peters B, Vogt M, Vogel M, Abdul-Khaliq H. Assessment of interventricular and right-intraventricular dyssynchrony in patients with surgically repaired tetralogy of Fallot by two-dimensional speckle tracking. Eur J Echocardiogr. 2010 Oct;11(9):786-92. doi: 10.1093/ejechocard/jeq067. Epub 2010 May 30.

    PubMed 20513701
  • Riesenkampff E, Mengelkamp L, Mueller M, Kropf S, Abdul-Khaliq H, Sarikouch S, Beerbaum P, Hetzer R, Steendijk P, Berger F, Kuehne T. Integrated analysis of atrioventricular interactions in tetralogy of Fallot. Am J Physiol Heart Circ Physiol. 2010 Aug;299(2):H364-71. doi: 10.1152/ajpheart.00264.2010. Epub 2010 May 21.

    PubMed 20495149
  • Beerbaum P, Barth P, Kropf S, Sarikouch S, Kelter-Kloepping A, Franke D, Gutberlet M, Kuehne T. Cardiac function by MRI in congenital heart disease: impact of consensus training on interinstitutional variance. J Magn Reson Imaging. 2009 Nov;30(5):956-66. doi: 10.1002/jmri.21948.

    PubMed 19856409
  • Bodhey NK, Beerbaum P, Sarikouch S, Kropf S, Lange P, Berger F, Anderson RH, Kuehne T. Functional analysis of the components of the right ventricle in the setting of tetralogy of Fallot. Circ Cardiovasc Imaging. 2008 Sep;1(2):141-7. doi: 10.1161/CIRCIMAGING.108.783795. Epub 2008 Jul 30.

    PubMed 19808531
  • Diller GP, Vahle J, Radke R, Vidal MLB, Fischer AJ, Bauer UMM, Sarikouch S, Berger F, Beerbaum P, Baumgartner H, Orwat S; German Competence Network for Congenital Heart Defects Investigators. Utility of deep learning networks for the generation of artificial cardiac magnetic resonance images in congenital heart disease. BMC Med Imaging. 2020 Oct 8;20(1):113. doi: 10.1186/s12880-020-00511-1.

    PubMed 33032536
  • Orwat S, Diller GP, Kempny A, Radke R, Peters B, Kuhne T, Boethig D, Gutberlet M, Dubowy KO, Beerbaum P, Sarikouch S, Baumgartner H; German Competence Network for Congenital Heart Defects Investigators. Myocardial deformation parameters predict outcome in patients with repaired tetralogy of Fallot. Heart. 2016 Feb;102(3):209-15. doi: 10.1136/heartjnl-2015-308569. Epub 2015 Dec 29.

    PubMed 26715570
  • Sarikouch S, Boethig D, Peters B, Kropf S, Dubowy KO, Lange P, Kuehne T, Haverich A, Beerbaum P; Investigators of the German Competence Network for Congenital Heart Defects. Poorer right ventricular systolic function and exercise capacity in women after repair of tetralogy of fallot: a sex comparison of standard deviation scores based on sex-specific reference values in healthy control subjects. Circ Cardiovasc Imaging. 2013 Nov;6(6):924-33. doi: 10.1161/CIRCIMAGING.112.000195. Epub 2013 Oct 16.

    PubMed 24132714
  • Kutty S, Kuehne T, Gribben P, Reed E, Li L, Danford DA, Beerbaum PB, Sarikouch S. Ascending aortic and main pulmonary artery areas derived from cardiovascular magnetic resonance as reference values for normal subjects and repaired tetralogy of Fallot. Circ Cardiovasc Imaging. 2012 Sep 1;5(5):644-51. doi: 10.1161/CIRCIMAGING.112.973073. Epub 2012 Jun 22.

    PubMed 22730421

Questions about this trial

What is this clinical trial studying?

An observational study of Tetralogy of Fallot, run by Competence Network for Congenital Heart Defects at 14 sites in Germany.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 5 inclusion and 9 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 21 Sep 2011. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 14 sites in Germany. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

- Assessment of the biventricular function via MRI, colour Doppler echocardiography, tissue Doppler and strain-rate imaging in correlation with objective exercise tolerance. The study lists 6 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT00266188, which also lists 9 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 21 Sep 2011.

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