Vladimiro L Vida1, Alvise Guariento1, Biagio Castaldi2, Matteo Sambugaro3, Massimo A Padalino1, Ornella Milanesi2, Giovanni Stellin4. 1. Department of Cardiac, Thoracic and Vascular Surgery, Pediatric and Congenital Cardiac Surgery Unit, University of Padua, Padua, Italy. 2. Department of Pediatrics, Pediatric Cardiology Unit, University of Padua, Padua, Italy. 3. Statistics Consultant, Department of Cardiac, Thoracic and Vascular Surgery, University of Padua, Padua, Italy. 4. Department of Cardiac, Thoracic and Vascular Surgery, Pediatric and Congenital Cardiac Surgery Unit, University of Padua, Padua, Italy. Electronic address: giovannistellin@unipd.it.
Abstract
BACKGROUND: The aim of the study was to evaluate our results with pulmonary valve (PV) preservation in selected patients with tetralogy of Fallot (TOF). METHODS: From January 2007, 69 patients who underwent early transatrial TOF repair were enrolled in the study. The patients were divided into 2 groups: PV preservation by PV annulus balloon dilation (group 1) and PV cusp reconstruction after annular incision (group 2). RESULTS: Thirty-four patients underwent a successful PV annular preservation (49%). Median age at surgery was 113 days (range, 36-521 days) (group-1 vs group-2, P = not significant). Median preoperative PV Z score was -3.15 (range, -0.95 to -5.62) (group-1 vs group-2, P = .03). Median intensive care unit and hospital stays were 3 and 10 days, respectively (group 1 vs group 2, P = not significant). Median follow-up time was 580 days (range, 189-1940 days) (group 1 vs group 2, P = .08). Two patients were reoperated for residual right ventricular outflow tract (RVOT) obstruction (1 in group 1 and 1 in group 2). The remaining patients are alive and well. Median peak RVOT gradient was 25 mm Hg (range, 8-60 mm Hg) (group 1 vs group 2, P = not significant). The degree of PV regurgitation in group 1 was none/mild in 24 patients (80%) and moderate in 6 (20%) and was none/mild in 8 patients (25%), moderate in 11 (34.4%), and severe in 13 (28.6%) in group 2 (P = .001). Median right ventricular fractional area change was 55% (range, 42%-70%) in group 1 and 50% (range, 40%-63%) in group 2 (P = .003). CONCLUSIONS: The integrity and function of the PV can be preserved in selected patients during early repair of TOF by concomitant balloon dilation, leading to a better mid-term right ventricular function.
BACKGROUND: The aim of the study was to evaluate our results with pulmonary valve (PV) preservation in selected patients with tetralogy of Fallot (TOF). METHODS: From January 2007, 69 patients who underwent early transatrial TOF repair were enrolled in the study. The patients were divided into 2 groups: PV preservation by PV annulus balloon dilation (group 1) and PV cusp reconstruction after annular incision (group 2). RESULTS: Thirty-four patients underwent a successful PV annular preservation (49%). Median age at surgery was 113 days (range, 36-521 days) (group-1 vs group-2, P = not significant). Median preoperative PV Z score was -3.15 (range, -0.95 to -5.62) (group-1 vs group-2, P = .03). Median intensive care unit and hospital stays were 3 and 10 days, respectively (group 1 vs group 2, P = not significant). Median follow-up time was 580 days (range, 189-1940 days) (group 1 vs group 2, P = .08). Two patients were reoperated for residual right ventricular outflow tract (RVOT) obstruction (1 in group 1 and 1 in group 2). The remaining patients are alive and well. Median peak RVOT gradient was 25 mm Hg (range, 8-60 mm Hg) (group 1 vs group 2, P = not significant). The degree of PV regurgitation in group 1 was none/mild in 24 patients (80%) and moderate in 6 (20%) and was none/mild in 8 patients (25%), moderate in 11 (34.4%), and severe in 13 (28.6%) in group 2 (P = .001). Median right ventricular fractional area change was 55% (range, 42%-70%) in group 1 and 50% (range, 40%-63%) in group 2 (P = .003). CONCLUSIONS: The integrity and function of the PV can be preserved in selected patients during early repair of TOF by concomitant balloon dilation, leading to a better mid-term right ventricular function.
Keywords:
20; 35; PV; RCA; RV; RVFAC; RVOT; TOF; VSD; pulmonary valve; right coronary artery; right ventricle fraction of area change; right ventricular; right ventricular outflow tract; tetralogy of Fallot; ventricular septal defect
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: Ming Wu; Chengming Fan; Jian Liu; Chukwuemeka Daniel Iroegbu; Wangping Chen; Peng Huang; Mi Tang; Xun Wu; Chunle Wang; Kun Xiang; Wenwu Zhou; Jinfu Yang Journal: Front Cardiovasc Med Date: 2021-11-26