Pulmonary valve replacement in patients with corrected tetralogy of Fallot
| Autor: | Andrew C. Chatzis, Christos Ntellos, Periklis A. Davlouros, Constantinos Loukas, Meletios A. Kanakis, Fotios M. Mitropoulos, Theophili Kousi |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2017 |
| Předmět: |
Reoperation
medicine.medical_specialty lcsh:Diseases of the circulatory (Cardiovascular) system Adult Congenital Heart Disease Pulmonary insufficiency 030204 cardiovascular system & hematology 03 medical and health sciences 0302 clinical medicine Internal medicine medicine.artery Pulmonary Valve Replacement medicine 030212 general & internal medicine Congenital Heart Surgery Tetralogy of Fallot Pulmonary Valve Tricuspid valve business.industry Extracorporeal circulation Perioperative medicine.disease 3. Good health Surgery medicine.anatomical_structure lcsh:RC666-701 Pulmonary valve Pulmonary artery Cardiology Original Article Cardiology and Cardiovascular Medicine business |
| Zdroj: | Journal of Cardiovascular and Thoracic Research, Vol 9, Iss 2, Pp 71-77 (2017) Journal of Cardiovascular and Thoracic Research |
| ISSN: | 2008-6830 2008-5117 |
| Popis: | Introduction: Development of pulmonary insufficiency in patients with surgically corrected tetralogy of Fallot (TOF) may lead to severe right heart failure with serious consequences. We herein present our experience with pulmonary valve replacement (PVR) in these patients. Methods: From 2005-2013, 99 consecutive patients (71 males/28 females, mean age 38±8 years), underwent PVR after 7 to 40 (mean 29 ± 8) years from the initial correction. Seventy nine of the symptomatic patients presented in NYHA II, 14 in III and 2 in IV. All underwent PVR with a stented bioprosthetic valve, employing a beating heart technique with normothermic extracorporeal circulation support. Concomitant procedures included resection of aneurysmal outflow tract patches (n = 37), tricuspid valve annuloplasty (n = 36), augmentation of stenotic pulmonary arteries (n = 9), maze procedure (n = 2) and pulmonary artery stenting (n = 4). Results: There were 2 perioperative deaths (2%). One patient developed sternal dehiscence requiring rewiring. Median ICU and hospital stay was 1 and 7 days respectively. Postoperative echocardiography at 6 and 12 months showed excellent bioprosthetic valve performance, significant decrease in size of the right cardiac chambers and reduction of tricuspid regurgitation (TR) in the majority of the patients. At mean follow-up of 3.6 ± 2 years, all surviving patients remain in excellent clinical condition. Conclusion: Probability of reoperation for pulmonary insufficiency in patients with surgically corrected TOF increases with time and timely PVR by preventing the development of right heart failure is crucial for long-term survival. Current bioprosthetic valve technology in combination with the beating heart technique provides excellent immediate and short-term results. Further follow-up is necessary to evaluate long-term outcome. |
| Databáze: | OpenAIRE |
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