Cardiology Today

Novel R.V.O.T. Repair in Tetralogy of Fallot 11/24/25


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Welcome to Cardiology Today – Recorded November 24, 2025. This episode summarizes 5 key cardiology studies on topics like atrial septal defect and dextrocardia. Key takeaway: Novel R.V.O.T. Repair in Tetralogy of Fallot.

Article Links:

Article 1: An Encouraging Approach to Complex ASDs: A Multicenter Study. (Pediatric cardiology)

Article 2: Parallel Transcatheter Valve and Stent Placement with Subsequent Stent Occlusion to Address a Giant Dysfunctional RVOT in a Patient with Repaired Tetralogy of Fallot. (Pediatric cardiology)

Article 3: Incidental diagnosis of a complex cyanotic congenital heart defect in a 32-year-old with orbital abscess. (Cardiology in the young)

Article 4: Balcinrenone in combination with dapagliflozin compared with dapagliflozin alone in patients with chronic kidney disease and albuminuria: a randomised, active-controlled double-blind, phase 2b clinical trial. (Lancet (London, England))

Article 5: Global, regional, and national burden of chronic kidney disease in adults, 1990-2023, and its attributable risk factors: a systematic analysis for the Global Burden of Disease Study 2023. (Lancet (London, England))

Full episode page: https://podcast.explainheart.com/podcast/novel-r-v-o-t-repair-in-tetralogy-of-fallot-11-24-25/

Featured Articles
Article 1: An Encouraging Approach to Complex ASDs: A Multicenter Study.

Journal: Pediatric cardiology

PubMed Link: https://pubmed.ncbi.nlm.nih.gov/41269259

Summary: The study found that transcatheter closure was performed in patients with complex atrial septal defects presenting with challenging conditions such as large defects, rim deficiency, or multifenestrated defects. This multicenter retrospective analysis evaluated the application of transcatheter techniques in cases where surgical repair might traditionally be preferred. The inclusion of patients with low age and weight also demonstrated the broad application of this approach. This indicates an encouraging expansion of percutaneous atrial septal defect closure to more complicated anatomies.

Article 2: Parallel Transcatheter Valve and Stent Placement with Subsequent Stent Occlusion to Address a Giant Dysfunctional RVOT in a Patient with Repaired Tetralogy of Fallot.

Journal: Pediatric cardiology

PubMed Link: https://pubmed.ncbi.nlm.nih.gov/41269258

Summary: A novel transcatheter approach successfully addressed a giant dysfunctional right ventricular outflow tract in a patient with repaired Tetralogy of Fallot and severe pulmonary insufficiency. This innovative strategy involved the parallel placement of a transcatheter valve and a stent, followed by subsequent stent occlusion. This method offered an alternative to open surgery in a complex anatomical case where conventional pulmonary valve replacement options were challenging. The procedure effectively managed right ventricular dilation and arrhythmia risk associated with the dysfunctional outflow tract.

Article 3: Incidental diagnosis of a complex cyanotic congenital heart defect in a 32-year-old with orbital abscess.

Journal: Cardiology in the young

PubMed Link: https://pubmed.ncbi.nlm.nih.gov/41267525

Summary: A 32-year-old adult male was incidentally diagnosed with a complex cyanotic congenital heart defect, including isolated dextrocardia, Double Inlet Left Ventricle (l-looped), and l-Transposed Great Arteries with subpulmonary stenosis. The patient survived into adulthood without cardiac surgeries or medications despite single ventricle physiology. This prolonged survival was attributed to a “self-banded” pulmonary flow, a protective physiological mechanism that naturally regulated pulmonary blood flow. This case highlights how unique compensatory mechanisms can enable long-term survival in severe congenital heart conditions.

Article 4: Balcinrenone in combination with dapagliflozin compared with dapagliflozin alone in patients with chronic kidney disease and albuminuria: a randomised, active-controlled double-blind, phase 2b clinical trial.

Journal: Lancet (London, England)

PubMed Link: https://pubmed.ncbi.nlm.nih.gov/41218621

Summary: Sodium glucose co-transporter two inhibitors, such as dapagliflozin, reduce albuminuria and the risk of chronic kidney disease progression. Non-steroidal mineralocorticoid receptor antagonists demonstrate similar benefits in patients with type two diabetes and chronic kidney disease. The MIRO-CKD multicenter, randomised, double-blind, active-controlled, phase 2b clinical trial investigated the efficacy and safety of the novel mineralocorticoid receptor antagonist balcinrenone in combination with dapagliflozin. This study explored a combination therapeutic approach building on the established benefits of each drug class for patients with chronic kidney disease and albuminuria.

Article 5: Global, regional, and national burden of chronic kidney disease in adults, 1990-2023, and its attributable risk factors: a systematic analysis for the Global Burden of Disease Study 2023.

Journal: Lancet (London, England)

PubMed Link: https://pubmed.ncbi.nlm.nih.gov/41213283

Summary: Chronic kidney disease consistently ranks among the leading causes of global mortality and morbidity. This systematic analysis for the Global Burden of Disease Study 2023 provided extensive global, regional, and national chronic kidney disease estimates for adults aged 20 years and older. The data, covering 204 countries and territories from 1990 to 2023, delivers crucial information to inform evidence-based policies. These findings are essential for targeted strategies in chronic kidney disease identification and treatment worldwide.

Transcript

Today’s date is November 24, 2025. Welcome to Cardiology Today. Here are the latest research findings.

Article number one. An Encouraging Approach to Complex ASDs: A Multicenter Study. The study found that transcatheter closure was performed in patients with complex atrial septal defects presenting with challenging conditions such as large defects, rim deficiency, or multifenestrated defects. This multicenter retrospective analysis evaluated the application of transcatheter techniques in cases where surgical repair might traditionally be preferred. The inclusion of patients with low age and weight also demonstrated the broad application of this approach. This indicates an encouraging expansion of percutaneous atrial septal defect closure to more complicated anatomies.

Article number two. Parallel Transcatheter Valve and Stent Placement with Subsequent Stent Occlusion to Address a Giant Dysfunctional RVOT in a Patient with Repaired Tetralogy of Fallot. A novel transcatheter approach successfully addressed a giant dysfunctional right ventricular outflow tract in a patient with repaired Tetralogy of Fallot and severe pulmonary insufficiency. This innovative strategy involved the parallel placement of a transcatheter valve and a stent, followed by subsequent stent occlusion. This method offered an alternative to open surgery in a complex anatomical case where conventional pulmonary valve replacement options were challenging. The procedure effectively managed right ventricular dilation and arrhythmia risk associated with the dysfunctional outflow tract.

Article number three. Incidental diagnosis of a complex cyanotic congenital heart defect in a 32-year-old with orbital abscess. A 32-year-old adult male was incidentally diagnosed with a complex cyanotic congenital heart defect, including isolated dextrocardia, Double Inlet Left Ventricle (l-looped), and l-Transposed Great Arteries with subpulmonary stenosis. The patient survived into adulthood without cardiac surgeries or medications despite single ventricle physiology. This prolonged survival was attributed to a “self-banded” pulmonary flow, a protective physiological mechanism that naturally regulated pulmonary blood flow. This case highlights how unique compensatory mechanisms can enable long-term survival in severe congenital heart conditions.

Article number four. Balcinrenone in combination with dapagliflozin compared with dapagliflozin alone in patients with chronic kidney disease and albuminuria: a randomised, active-controlled double-blind, phase 2b clinical trial. Sodium glucose co-transporter two inhibitors, such as dapagliflozin, reduce albuminuria and the risk of chronic kidney disease progression. Non-steroidal mineralocorticoid receptor antagonists demonstrate similar benefits in patients with type two diabetes and chronic kidney disease. The MIRO-CKD multicenter, randomised, double-blind, active-controlled, phase 2b clinical trial investigated the efficacy and safety of the novel mineralocorticoid receptor antagonist balcinrenone in combination with dapagliflozin. This study explored a combination therapeutic approach building on the established benefits of each drug class for patients with chronic kidney disease and albuminuria.

Article number five. Global, regional, and national burden of chronic kidney disease in adults, 1990-2023, and its attributable risk factors: a systematic analysis for the Global Burden of Disease Study 2023. Chronic kidney disease consistently ranks among the leading causes of global mortality and morbidity. This systematic analysis for the Global Burden of Disease Study 2023 provided extensive global, regional, and national chronic kidney disease estimates for adults aged 20 years and older. The data, covering 204 countries and territories from 1990 to 2023, delivers crucial information to inform evidence-based policies. These findings are essential for targeted strategies in chronic kidney disease identification and treatment worldwide.

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Keywords

atrial septal defect, dextrocardia, Double Inlet Left Ventricle, transcatheter closure, congenital heart defect, albuminuria, single ventricle physiology, epidemiology, Sodium glucose co-transporter two inhibitors, pediatric cardiology, global burden of disease, pulmonary insufficiency, Tetralogy of Fallot, balcinrenone, dapagliflozin, subpulmonary stenosis, chronic kidney disease, complex congenital heart disease, Transposed Great Arteries, right ventricular outflow tract, risk factors, transcatheter pulmonary valve replacement, mineralocorticoid receptor antagonists, morbidity, mortality.

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