TURBT, previous tetralogy of fallot

Gabrielle Morris

66yo Cystoscopy + TURBT for bladder amyloidosis. Recent admission with haematuria and clot retention. 

Background

  • Tetralogy of Fallot: full correction at 17yo. Tissue valve replacement (?which valve) in 2011
  • AICD+PPM for CHB: 2 shocks (last in 2010). Paced 85% of time
  • OSA – adherent to CPAP
  • Amyloidosis – localized to bladder. No systemic manifestations

Issues

  • PTSD from procedures as child – wanting to avoid procedures where possible
  • Surgical options: ?flexible cystoscopy, but will require yearly TURBT
  • Increased SOBOE: awaiting cardiology review and ECHO

Discussion

  • Reasonable to await cardiology review
  • Avoidance of procedure now (with conservative flexi cystoscopy) likely to lead to further hospital admissions with haematuria/retention and unlikely to avoid need for procedure
  • Tetralogy of Fallot:
    • VSD with overriding aorta, RV outflow tract obstruction and RV hypertrophy
    • Presents in the neonatal period with murmur and/or cyanosis
    • In present times, patients usually undergo complete intracardiac repair during the neonatal or infant period
    • Common long term complications of repair include pulmonary regurgitation, RV failure, atrial arrhythmias, and ventricular arrhythmias. 

Plan

  • Await cardiology review and TTE