OBJECTIVE: To evaluate the application value of simultaneous enlargement of the pulmonary annulus and the pulmonary cusp with a transannular patch of autologous pericardium in right ventricular outflow tract (RVOT) reconstruction. METHODS: Thirty-two patients who had complex congenital heart diseases received the technique between Jan. 2003 and Dec. 2005. Two surgical approaches were developed to construct a competent neocusp with autologous pericardium that could be extended through the pulmonary valve annulus or valve commissures. RESULTS: There was only 1 early death. The postoperative complications occurred in 6 patients recovered uneventfully. The results of the 4 approximately 40 month follow-up in 31 patients showed good motion of reconstructed cusps. 17 patients had no or trivial pulmonary insufficiency. There was mild insufficiency in 12 patients and moderate insufficiency in 2. None of these patients needed reoperations. CONCLUSION: The surgical technique of simultaneous enlargement of the pulmonary annulus and the pulmonary cusp with a transannular patch of autologous pericardium is a safe, reliable and effective way for RVOT reconstruction. However, further close follow-up is needed to determine the true value of this technique.
OBJECTIVE: To evaluate the application value of simultaneous enlargement of the pulmonary annulus and the pulmonary cusp with a transannular patch of autologous pericardium in right ventricular outflow tract (RVOT) reconstruction. METHODS: Thirty-two patients who had complex congenital heart diseases received the technique between Jan. 2003 and Dec. 2005. Two surgical approaches were developed to construct a competent neocusp with autologous pericardium that could be extended through the pulmonary valve annulus or valve commissures. RESULTS: There was only 1 early death. The postoperative complications occurred in 6 patients recovered uneventfully. The results of the 4 approximately 40 month follow-up in 31 patients showed good motion of reconstructed cusps. 17 patients had no or trivial pulmonary insufficiency. There was mild insufficiency in 12 patients and moderate insufficiency in 2. None of these patients needed reoperations. CONCLUSION: The surgical technique of simultaneous enlargement of the pulmonary annulus and the pulmonary cusp with a transannular patch of autologous pericardium is a safe, reliable and effective way for RVOT reconstruction. However, further close follow-up is needed to determine the true value of this technique.