Effect of Pulmonary Valve Replacement in the Repaired Tetralogy of Fallot Patients with Trans-annular Incision: More than 20 Years of Follow-up
| Autor: | Woong Han Kim, Jae Gun Kwak, Gi Beom Kim, Jeong Ryul Lee, Hong Ju Shin, Ji Hyun Bang, Mi Kyoung Song, Eung Re Kim, Eun Jung Bae |
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| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
Pulmonary valve Pulmonary regurgitation 030204 cardiovascular system & hematology Sudden death 03 medical and health sciences 0302 clinical medicine Interquartile range Pulmonary Valve Replacement Internal Medicine medicine 030212 general & internal medicine Adverse effect Tetralogy of Fallot Original Research Congenital heart disease business.industry Hazard ratio medicine.disease eye diseases Surgery medicine.anatomical_structure sense organs Cardiology and Cardiovascular Medicine business Shunt (electrical) |
| Zdroj: | Korean Circulation Journal |
| ISSN: | 1738-5520 |
| Popis: | BACKGROUND AND OBJECTIVES We reviewed the long-term outcomes after tetralogy of Fallot (TOF) repair with trans-annular incision; and evaluated the effectiveness of pulmonary valve replacement (PVR) on outcomes. METHODS This was a retrospective review of clinical outcomes of 180 of 196 TOF patients who underwent total correction with trans-annular incision from 1991 to 1997 (PVR group: 81; non-PVR group: 99). RESULTS The median age of the patients was 14.0 months (interquartile range [IQR], 10.7-19.8 months) at TOF repair. Ten in-hospital deaths (5.1%) occurred. During the follow-up, 81 patients underwent PVR at the median age of 13.5 years (IQR, 11.2-17.1 years). The patients in PVR group showed better outcomes than non-PVR group in overall survival rate (100% in PVR vs. 88.7% in non-PVR, p=0.007), in all adverse events (arrhythmia, neurologic complications, 95.5% in PVR vs. 74.6% in non-PVR, p=0.024) at 20 years. Age at TOF repair younger than 1 year (hazard ratio [HR], 2.265; p=0.01) and previous shunt history (HR, 2.195; p=0.008) were predictive for requiring PVR. During follow-up, 10 late deaths (5 sudden deaths) occurred in the non-PVR group, mainly due to ventricular arrhythmia and right ventricular failure; there was 1 late death (not a sudden death) in the PVR group. CONCLUSIONS Long-term survival after repair of TOF with trans-annular incision were acceptable. However, arrhythmias were frequently observed during 20 years of follow-up. The patient age |
| Databáze: | OpenAIRE |
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