Author's summary Pulmonary arterial elastance in repaired TOF with low RV pressure was negatively correlated with pulmonary regurgitation (PR) severity, which may prevent PR, right ventricular (RV) dilatation, and left ventricular dilatation in the absence of significant pulmonary stenosis. Although many previous studies focused primarily on RV volume, the situation in patients with repaired tetralogy of Fallot is more complicated because pulmonary arterial elastance and compliance affect PR severity and RV volume. Our study showed that in low pulmonary arterial elastance group among repaired Tetralogy of Fallot with low RV pressure, RV and LV stroke volume is increased after pulmonary valve replacement and related to increased exercise capacity.

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Author's summary On January 7th, 2022, a historical event of pig-to-human cardiac xenotransplantation was performed using genetically engineered porcine xenograft and co-stimulation blockade-based immunosuppression. Though the patient developed xenograft failure and succumbed to death on post-operative day 60, this event shed light on the cumulative effect of scientists and physicians who worked hard to unveil the underlying immunobiology of cross-species organ transplantation. In this review, we will summarize major advances along the history of cardiac xenotransplantation, current status in Korea, and remaining challenges.

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