Publication Date
6-1-2016
Journal
The Texas Heart Journal
DOI
10.14503/THIJ-14-4609
PMID
27303235
Publication Date(s)
June 2016
Language
English
PMCID
PMC4894698
PubMedCentral® Posted Date
6-1-2016
PubMedCentral® Full Text Version
Post-Print
Published Open-Access
yes
Keywords
Age factors, child, pericardium/transplantation, postoperative complications/prevention & control, pulmonary valve insufficiency/etiology/surgery, retrospective studies, tetralogy of Fallot/complications, transplantation, autologous/methods, ventricular outflow obstruction/surgery
Copyright
This work is licensed under a Creative Commons Attribution-NonCommercial-No Derivative Works 4.0 International License.
Abstract
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 retrospectively evaluated the efficacy of a reconstructed pulmonary valve and annulus in 70 patients who underwent, from December 2006 through December 2010, complete correction of tetralogy of Fallot. We divided the 70 patients into 2 groups in accordance with whether they required (n=50) or did not require (n=20) a TAP. We used autologous untreated pericardium to fashion the TAP and to create both an annulus of the correct size and a competent pulmonary valve with native leaflets. We evaluated the efficiency of this procedure both functionally and anatomically.
The median age of the patients was 11 years (range, 2–38 yr). There were 56 males, with no significant difference in sexual distribution between groups. The clinical follow-up was 88% for 57.5 months, and the echocardiographic follow-up was 80% for 36 months. There was no significant difference in outflow gradient or in the occurrence of pulmonary insufficiency between the TAP group (none, 31; mild, 12; moderate, 6; and severe, 1) and the No-TAP group (none, 16; moderate, 2; and severe, 2) (P=0.59). Nor was there any thickening or calcification in the constructed valves.
We conclude that pulmonary valves constructed of untreated autologous pericardium performed as well as native valves after total tetralogy of Fallot correction at midterm.