A new pulmonary valve cusp plasty technique markedly decreases transannular patch rate and improves midterm outcomes of tetralogy of Fallot repair

Abstract

Excellent outcome can be achieved even with 95% freedom of TAP in complete repair of tetralogy. The function of most patients' pulmonary valve was well preserved.

Tetralogy of Fallot with an abnormal coronary artery: surgical options and prognostic factors

“…Postoperative ischaemic electric signs without any acute coronary syndrome during the hospital stay significantly increase the risk of long-term heart failure (OR = 26). The postoperative RV/LV pressure ratio is also directly linked to the quality of the surgical repair [21,22]. We demonstrated that an immediate postoperative RV/LV pressure ratio >0.5 was independently associated with a long-term RV/LV pressure ratio >0.5, but was not a risk factor for reoperation or mortality.…”

Spectrum of pulmonary valve morphology and its relationship to pulmonary trunk in tetralogy of Fallot

“…[2] The pulmonary valve morphology in patients with TOF is commonly abnormal, and most data in literature has been obtained from the study of surgical heart specimens during autopsy, which could be biased due to different survival rates of patients with various anatomic variations. Because of the current trends towards valve sparing techniques and native valve cusp augmentation techniques to reduce the incidence of pulmonary regurgitation and its long-term complications following corrective TOF repair,[34] preoperative awareness of pulmonary valve morphology could contribute towards better surgical planning. Multidetector cardiac computed tomography (CT) gives good anatomic detail of the cardia, its vascular structures, and valves.…”

Pulmonary Valve Preservation Strategies for Tetralogy of Fallot Repair

“…Under these circumstances, transannular patches were intentionally downsized and reconstructed to result in right ventricular gradients of approximately 20 mm Hg. 11,12 More comprehensive valve-sparing techniques that included a supravalvar pantaloon autologous pericardial patch for supravalvar pulmonary stenosis were highlighted by several authors. [8][9][10] These techniques permitted an increased incidence of pulmonary valve preservation during initial repair in up to 70% of patients 8 compared with 40% or less in other reports.…”