Long-term results of pulmonary valve annular enlargement with valve repair in tetralogy of Fallot

Abstract

PV annular enlargement with valve repair has reasonable long-term results and yields a lower long-term incidence of significant PR compared with the simple transannular patch enlargement technique.

Early results of neopulmonary valve creation technique using right atrial appendage tissue

“…In the literature, pulmonary valve repair methods have been reported along with pulmonary valve annulus enlargement. Kim et al 7 reported the long‐term outcomes of pulmonary annulus enlargement and valve repair to 43 patients. In the early period, the mean PI rates were 0.93 ± 0.40 and the mean RVOT gradients were 13.0 ± 10.9 mm Hg.…”

“…Various methods have been described for prevention of PI during RVOT reconstruction with transannular patch 1‐8 . These techniques include monocusp valve placement and anterior leaflet augmentation with polytetrafluoroethylene membranes.…”

“…Surgical treatment of tetralogy of fallot (TOF) has been performed with low mortality in most congenital heart centers 1,2 . However, the long‐term results of TOF repair have been compromised by pulmonary insufficiency (PI) and associated right ventricular dysfunction 1‐8 . Patients with TOF usually develop free PI in the 10‐ to 20‐year period after total correction, and 10% to 15% of them will need valve replacement 9,10 .…”

“…1,2 However, the longterm results of TOF repair have been compromised by pulmonary insufficiency (PI) and associated right ventricular dysfunction. [1][2][3][4][5][6][7][8] Patients with TOF usually develop free PI in the 10-to 20-year period after total correction, and 10% to 15% of them will need valve replacement. 9,10 A previous survey of the Society of Thoracic Surgeons Database has revealed that transannular patch repair remains the most prevalent technique.…”

Commentary: Valve-sparing approach to the hypoplastic pulmonary valve in tetralogy of Fallot repair

“…Although this series is small and its follow-up is limited, these results are impressive and quite thought-provoking. In comparison with other reported techniques for a functional valve-sparing repair, which mainly rely on cusp augmentation, 5,6 it appears that the potential advantage of the Padua group's approach 3 is the aggressive use of native tissue. The use of leaflet delamination extending into the subannular plane when necessary followed by leaflet resuspension avoids the need for any major nonanatomic (biologic or not) cusp reconstruction.…”