Factors related to the durability of a homograft monocusp valve inserted during repair of tetralogy of Fallot as based on the mid- to long-term outcomes

Yang, Ji-Hyuk; Jun, Tae-Gook; Park, Pyo W.; Sung, Kiick; Kim, Wook S.; Lee, Young T.; Huh, June; Kang, I-Seok; Lee, Heung J.

doi:10.1017/s1047951108001923

Cited by 16 publications

(6 citation statements)

References 19 publications

(41 reference statements)

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“…Sasson et al [ 7 ] reported that, compared with a TAP alone, monocusp reconstruction with a TAP shortened the length of stay in the intensive care unit, the duration of pleural drainage, and the ventilation time. However, despite early hemodynamic advantages, the effects of monocusp reconstruction are limited in duration due to progressive degeneration [ 8 ]. Almost all previous studies have examined a small number of patients with mixed characteristics.…”

Section: Introductionmentioning

confidence: 99%

“…Almost all previous studies have examined a small number of patients with mixed characteristics. Additionally, no mid-term or long-term surgical data assessing only TOF patients have been published [ 4 , 8 ]. The purpose of this study was to evaluate the mid-term surgical outcomes of monocusp reconstruction with a TAP used during TOF repair.…”

Section: Introductionmentioning

confidence: 99%

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Surgical Results of Monocusp Implantation with Transannular Patch Angioplasty in Tetralogy of Fallot Repair

Jang

Cho

Lee

et al. 2016

Korean J Thorac Cardiovasc Surg

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BackgroundMonocusp reconstruction with a transannular patch (TAP) results in early improvement because it relieves residual volume hypertension during the immediate postoperative period. However, few reports have assessed the long-term surgical outcomes of this procedure. The purpose of the present study was to evaluate the mid-term surgical outcomes of tetralogy of Fallot (TOF) repair using monocusp reconstruction with a TAP.MethodsBetween March 2000 and March 2009, 36 patients with a TOF received a TAP. A TAP with monocusp reconstruction (group I) was used in 25 patients and a TAP without monocusp reconstruction (group II) was used in 11 patients. We evaluated hemodynamic parameters using echocardiography during the follow-up period in both groups.ResultsAt the most recent follow-up echocardiography (mean follow-up, 8.2 years), the mean pulmonary valve velocities of the patients in group I and group II were 2.1±1.0 m/sec and 0.9±0.9 m/sec, respectively (p=0.001). Although the incidence of grade 3–4 pulmonary regurgitation (PR) was not significantly different between the two groups (group I: 16 patients, 64.0%; group II: 7 patients, 70.0%; p=0.735) during the follow-up period, the interval between the treatment and the incidence of PR aggravation was longer in group I than in group II (group I: 6.5±3.4 years; group II: 3.8±2.2 years; p=0.037).ConclusionMonocusp reconstruction with a TAP prolonged the interval between the initial treatment and grade 3–4 PR aggravation. Patients who received a TAP with monocusp reconstruction to repair TOF were not to progress to pulmonary stenosis during the follow-up period as those who received a TAP without monocusp reconstruction.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Surgical Results of Monocusp Implantation with Transannular Patch Angioplasty in Tetralogy of Fallot Repair

Jang

Cho

Lee

et al. 2016

Korean J Thorac Cardiovasc Surg

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“…Reported techniques have included complete excision of the dilated PAs; a subtotal resection with flap augmentation and arteriopexy; an anterior or posterior resection with reduction of pulmonary arteries. The repair of pulmonary regurgitation and stenosis was done by a RV-PA valved conduit of homograft or heterograft tissue and the closure of the ventricular septal defect by a patch [3] [10]- [17].…”

Section: Discussionmentioning

confidence: 99%

Surgical Treatment of Tetralogy of Fallot with Pulmonary Valve Agenesis in a 22 Years Old Patient

Ba¹,

Yannick²,

Diop³

et al. 2021

WJCS

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Agenesis of pulmonary valve is a rare variant and severe form of Tetralogy of Fallot (ToF). The evolution is usually marked by respiratory and cardiac failure at early age, which needs early surgical correction. Uncorrected treatment of Tetralogy of Fallot diagnosed at adult age is infrequent and only few studies have been described. We present here a rare case of a 22 years old patient who presented with dyspnea since childhood. Subsequent investigations allowed diagnosis of treatment of Tetralogy of Fallot with agenesis of the pulmonary valve. Following the assessment, the patient underwent a surgical repair and the recovery was uneventful. The management of treatment of Tetralogy of Fallot with pulmonary valve agenesis in adult period remains complex, requiring different surgical techniques.

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“…26,27 Conversely, the construction of a monocusp from a homograft has been associated with destruction consequent to ABO blood group incompatibility, and with poor valvular function at midterm. 28 Although thin and impervious to the growth of fibrous tissue, PTFE is known to calcify in the long term. 29 It definitely has no growth potential.…”

Section: Supplemental Motion Image Is Available Formentioning

confidence: 99%

Fresh Autologous Pericardium to Reconstruct the Pulmonary Valve at the Annulus When Tetralogy of Fallot Requires a Transannular Patch at Midterm

Pande¹,

Sharma²,

Siddartha³

et al. 2016

Texas Heart Institute Journal

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Tetralogy of Fallot often requires reconstruction of the right ventricular outflow tract with a transannular patch (TAP), but this renders the pulmonary valve incompetent and eventually leads to right ventricular dysfunction.We P ulmonary insufficiency (PI) is an unwarranted side effect of the transannular patch (TAP) used for relieving the right ventricular outflow tract (RVOT) obstruction that is characteristic of tetralogy of Fallot (TOF).1 With time, the presence of PI causes right ventricular (RV) overload and eventually leads to RV dysfunction.2 Attempts to reduce insufficiency at the pulmonary valve (PV)-such as limiting the extent of infundibular incision or using a smaller transannular patch-have met with limited success.3,4 A TAP for RVOT reconstruction relieves its obstruction; but its expansion, especially at the level of the PV, cannot be governed, and this results in free pulmonary regurgitation. The use of a smaller TAP not only fails to relieve the RVOT obstruction efficiently but is unable to curtail the free PI. A procedure that can resolve the problem of PI with relief of RVOT obstruction must fulfill these 2 criteria: 1) limit the expanse of the TAP at the level of the native PV, while enabling it to bulge (and thereby increase the room in the RVOT to relieve obstruction) and 2) provide a competent PV. This study evaluates the efficiency of one such procedure at creating a competent PV complex (that is, a competent PV and a new pulmonary annulus) in TOF patients who need a TAP for relief of RVOT obstruction when undergoing complete intracardiac repair. This procedure was tested at midterm follow-up. Patients and MethodsThis is a retrospective analysis of 70 cases of children who underwent total cardiac repair for TOF

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Factors related to the durability of a homograft monocusp valve inserted during repair of tetralogy of Fallot as based on the mid- to long-term outcomes

Cited by 16 publications

References 19 publications

Surgical Results of Monocusp Implantation with Transannular Patch Angioplasty in Tetralogy of Fallot Repair

Surgical Results of Monocusp Implantation with Transannular Patch Angioplasty in Tetralogy of Fallot Repair

Surgical Treatment of Tetralogy of Fallot with Pulmonary Valve Agenesis in a 22 Years Old Patient

Fresh Autologous Pericardium to Reconstruct the Pulmonary Valve at the Annulus When Tetralogy of Fallot Requires a Transannular Patch at Midterm

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