Adail Orrith Liborio Neto
Federal University of Rio de Janeiro Campus Macae, Brazil
Academic and Intern of Medicine at the Federal University of Rio de Janeiro Campus Macae (UFRJ Macaé). Currently working in research in the area of Neonatal Clinical Microbiology as a student PIBIC UFRJ Working in the areas of Clinical Pathology and Nutrition and Gynecology and Obstetrics. I worked in the project Prevalence of congenital toxoplasmosis in an endemic area for toxoplasmosis in northern Rio de Janeiro. QualiVida project extensionist - Multidisciplinary intervention as a health health strategy in the objectives of the University City of Macaé - Rio de Janeiro, linked to the Laboratory of Research and Innovation in Sports Sciences - LAPICE UFRJ Macaé. He was an intern at the Cardiology outpatient clinic at the Dr. Jorge Caldas Health Center. Currently, trainee in Rheumatology at Cliged Macae.
Tetralogy of Fallot consists of four cardiac changes: interventricular communication, pulmonary stenosis, aortic dextroposition and right ventricular hypertrophy. The prevalence is 0.21 per 1,000 live births, corresponding to approximately 3.36% of congenital heart diseases. A primiparous mother with gestational age of 38 weeks and without proof of prenatal exams came to the emergency. At the time of the obstetric examination, it was verified in her twin pregnancy that one fetus had tetralogy of Fallot, thus being scheduled pregnancy interruption for the following day. The first female twin had an Apgar score of 7 and 8, 2640 g and length: 46 cm. The second female twin had an Apgar score of 8 and 8, 3015 g and length: 47.5 cm. In the neonatal physical examination of both, were found localized acrocyanosis, regular heart rhythm with the presence of pancardic murmur and good peripheral perfusion. The echocardiogram of first twin revealed: patent foramen ovale, wide perimembranous interventricular communication of misalignment with aorta riding the septum by 50%, hypertrophied infundibulum with pulmonary infundibulo-valvular stenosis with Δmax 66mm Hg and long, confluent and small pulmonary arteries measuring APD: 0.35 and APE: 0.35, pulmonary valve annulus: 0.56 and patent ductus arteriosus measuring 0.19 mm. The echocardiogram of second twin showed: patent foramen ovale, wide perimembranous interventricular communication of misalignment with aorta riding the septum by 50%, hypertrophied infundibulum with stenosis pulmonary infundibulo-valve with Δmax of 33 mm Hg, reduced confluent pulmonary arteries measuring APD : 0.40 and APE: 0.55, pulmonary valve annulus: 0.72, closed arterial canal and mild aortic regurgitation. Tetralogy of Fallot is a multifaceted syndrome, underreported and with a high prevalence in pediatrics.. According to research done in the Literature this case is, so far, the first case of congenital heart defect concordance for TOF in monozygotic twins in Brazil.