Key result
Pulmonary annulus preservation in ToF repair is linked to ~74% shorter ventilation time vs transannular patch.
Why the study?
Tetralogy of Fallot repair can involve pulmonary valve annulus preservation or a transannular patch with a PTFE bicuspid valve, but short-term comparative outcomes required evaluation.
Does PVA-preserving repair improve early postoperative recovery in TOF patients compared to TAP with a PTFE bicuspid valve?
Observational (n=46)
No
Does PVA-preserving repair improve early postoperative recovery in TOF patients compared to TAP with a PTFE bicuspid valve?
Absolute Event Rate: 5% vs 19%
p-value: p=0.001
PVA-preserving TOF repair is associated with better early recovery metrics, though TAP with a PTFE bicuspid valve remains a safe and effective alternative when valve preservation is anatomically unfeasible.
May improve early recovery in feasible TOF cases; extends observational evidence for PVA preservation versus TAP.
Background: Tetralogy of Fallot (TOF) repair may involve either preservation of the pulmonary valve annulus (PVA) or use of a transannular patch (TAP) with a polytetrafluoroethylene (PTFE) bicuspid pulmonary valve. This study aimed to compare short-term clinical and echocardiographic outcomes of TOF repair using preserved PVA versus TAP with PTFE valve. Methods: This prospective, comparative, cross-sectional study was conducted from January 2022 to December 2023 at the National Heart Foundation Hospital & Research Institute, Dhaka. A total of 46 TOF patients were enrolled: 23 underwent PVA-preserving repair (Group A) and 23 received TAP with PTFE bicuspid valve (Group B). Data on postoperative ventilation time, vasoactive inotrope score (VIS), intensive care unit (ICU) stay, morbidity, and echocardiographic parameters were collected up to 12 weeks post discharge. Statistical analysis was performed using Mann-Whitney U and Fisher’s exact tests. Results: Group A demonstrated significantly shorter ventilation time (median 5.0 vs. 19.0 hours, p = 0.001), lower VIS (median 9.0 vs. 13.5, p = 0.002), and reduced ICU stay (median 6.0 vs. 7.0 days, p = 0.023). The tricuspid regurgitation peak pressure gradient was significantly lower in Group A at all follow-up points (p < 0.05). No significant differences were observed in overall morbidity, mortality, or incidence of pulmonary regurgitation and right ventricular dysfunction between groups, and no patient required immediate redo surgery for residual right ventricular outflow tract obstruction. Conclusion: PVA-preserving TOF repair is associated with better early recovery metrics. However, TAP with a PTFE bicuspid valve remains a safe and effective alternative when valve preservation is not feasible.
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Islam et al. (2026) conducted an observational in Tetralogy of Fallot (n=46). Pulmonary valve annulus (PVA) preservation vs. Transannular patch (TAP) with PTFE bicuspid pulmonary valve was evaluated on Duration of mechanical ventilation (median hours) (p=0.001). Pulmonary valve annulus preservation during Tetralogy of Fallot repair significantly reduced median ventilation time (5.0 vs 19.0 hours) and ICU stay (6.0 vs 7.0 days) compared to transannular patch.