INTRODUCTION AND OBJECTIVES: To report on our initial experience with the implantation of a pulmonary valve using Nunn's technique in association with a transannular patch for the complete repair of the tetralogy of Fallot. METHODS: In total, 21 patients were treated between September 2008 and February 2010. Their ages ranged from 7 months to 15 years (median 12 months) and weights from 6.8 kg to 44 kg (median 10 kg). Four patients had previously undergone palliative shunt placement; in two, it was associated with the diagnosis of a complete atrioventricular septal defect. Use of the transannular patch (treated autologous pericardium) was preceded by implantation of a 0.1-mm polytetrafluoroethylene (PTFE) monocusp valve using posterior fixation. Intraoperative transesophageal echocardiography and pressure gradient measurement were carried out, and echocardiography was repeated before discharge. RESULTS: No deaths were recorded. One patient had a residual ventricular septal defect that required reintervention. Echocardiography showed that the maximum gradient across the PTFE valve was 25 mmHg. Regurgitation was mild in 19 cases and moderate in 2 (the first and second in the series). CONCLUSIONS: Initial results using a transannular patch with a modified monocusp valve to repair the outflow tract in the tetralogy of Fallot were promising: there was only a slight pressure gradient and mild regurgitation. A medium-or long-term follow-up study is required to confirm these findings and to compare them with results obtained using other techniques.
INTRODUCTION AND OBJECTIVES: To report on our initial experience with the implantation of a pulmonary valve using Nunn's technique in association with a transannular patch for the complete repair of the tetralogy of Fallot. METHODS: In total, 21 patients were treated between September 2008 and February 2010. Their ages ranged from 7 months to 15 years (median 12 months) and weights from 6.8 kg to 44 kg (median 10 kg). Four patients had previously undergone palliative shunt placement; in two, it was associated with the diagnosis of a complete atrioventricular septal defect. Use of the transannular patch (treated autologous pericardium) was preceded by implantation of a 0.1-mm polytetrafluoroethylene (PTFE) monocusp valve using posterior fixation. Intraoperative transesophageal echocardiography and pressure gradient measurement were carried out, and echocardiography was repeated before discharge. RESULTS: No deaths were recorded. One patient had a residual ventricular septal defect that required reintervention. Echocardiography showed that the maximum gradient across the PTFE valve was 25 mmHg. Regurgitation was mild in 19 cases and moderate in 2 (the first and second in the series). CONCLUSIONS: Initial results using a transannular patch with a modified monocusp valve to repair the outflow tract in the tetralogy of Fallot were promising: there was only a slight pressure gradient and mild regurgitation. A medium-or long-term follow-up study is required to confirm these findings and to compare them with results obtained using other techniques.
Authors: Albert Franz Guerrero; Ivonne Gisel Pineda-Rodríguez; Andres Mauricio Palacio; Carlos Eduardo Obando; Tomas Chalela; Jaime Camacho; Carlos Villa; Juan Pablo Umaña; Nestor Fernando Sandoval-Reyes Journal: Interact Cardiovasc Thorac Surg Date: 2022-07-09
Authors: Selim Aydın; Dilek Suzan; Bahar Temur; Barış Kırat; Müzeyyen İyigün; İbrahim Halil Demir; Ender Ödemiş; Ersin Erek Journal: Turk Gogus Kalp Damar Cerrahisi Derg Date: 2018-07-03 Impact factor: 0.332