Key result
Review details surgical approach for stented bioprosthetic pulmonary valve replacement in repaired ToF.
Why the study?
More than 50% of children repaired for TOF with a transannular patch require PVR in early adulthood to prevent severe RV dilatation and its complications.
This paper outlines the surgical approach for pulmonary valve replacement using stented bioprostheses in older children and adults with repaired tetralogy of Fallot.
Offers a high-volume center's approach to stented bioprosthetic PVR in repaired TOF; leaves open need for comparative outcome data.
More than 50% of children who undergo repair of tetralogy of Fallot (TOF) using a transannular patch will require pulmonary valve replacement (PVR) in early adulthood. The premise of PVR in this setting is to ameliorate the relentless right ventricular (RV) dilatation that otherwise occurs in the presence of severe pulmonary regurgitation. Severe RV dilatation is associated with RV dysfunction, symptoms of exercise intolerance, tricuspid regurgitation and-occasionally-life-threatening RV failure or dangerous ventricular tachyarrhythmia. Increasingly, patients referred for PVR are asymptomatic young adults with busy lives and dependants. Redo cardiac surgery in this setting is high-stakes surgery. Here, we outline the surgical approach taken in a centre with a history of >1000 such operations.
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Halvorsen et al. (2016) conducted a review in Tetralogy of Fallot requiring pulmonary valve replacement. Pulmonary valve replacement using stented bioprostheses was evaluated. This paper outlines the surgical approach for pulmonary valve replacement using stented bioprostheses in older children and adults with repaired tetralogy of Fallot at a high-volume center.
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