The current strategy of repair of tetralogy of Fallot in children and adults

Abstract

Based on our experience, we suggest that the current strategy of repair of tetralogy of Fallot in older children and adults should be based on minimizing the insertion of transjunctional patches, this being indicated only in those with very small ventriculo-pulmonary junctions. If such a patch is necessary, then steps should be taken to preserve the function of the pulmonary valve.

A three-decade experience of radical open endvenectomy with pericardial patch graft for correction of Budd-Chiari syndrome

“…[4][5][6][7] It has been applied in many reconstructive procedures such as right ventricular outflow tract repair of tetralogy of Fallot, aortic arch reconstruction in hypoplastic left heart syndrome, heart valve repair, and aortic root repair in aortic valve endocarditis. [9][10][11][12][13][14][15] Our previous immunohistologic findings 8 also support the use of autologous pericardium for IVC reconstruction in terms of the quality of the neointima of grafts after patch reconstruction of the IVC in dogs. Moreover, the pericardium can be easily harvested through a thoracoabdominal incision approached through the retrohepatic IVC and RA in patients with BCS.…”

“…The mean pressure gradient between the RA and IVC was significantly decreased from 12.0 Ϯ 3.4 (range, [8][9][10][11][12][13][14][15][16][17][18][19][20][21] No graft infections developed during the mean follow-up period of 7.6 Ϯ 6.5 years (range, 0.08-24.1 years). Total obstruction of the reconstructed IVC occurred in three patients at 5, 6, and 7 years, respectively, after the initial surgery.…”

The Role of Tricuspid Valve Surgery in the Late Management of Tetralogy of Fallot

“…4,5,7 –9 Resection of hypertrophied muscle bundles provides an alternative means of relieving RVOT without causing significant PR when the pulmonary annulus is of adequate size. 48 In 1976, Edmunds et al 49 described RV infundibulum resection as a safe approach to treating outflow tract obstruction that does not injure chordae or papillary muscles. This procedure nevertheless carries the potential to disrupt the tricuspid tensor apparatus.…”

Identification of novel rare copy number variants associated with sporadic tetralogy of Fallot and clinical implications

“…Surgical correction is required as 25% of untreated infants born with TOF and pulmonary stenosis, which is a common comorbidity, die in the first year of life 3,4 . There may be differences among populations regarding the prevalence of TOF.…”

“…die in the first year of life. 3,4 There may be differences among populations regarding the prevalence of TOF. Studies suggest that the prevalence of TOF is substantially higher in China.…”