Outcomes of pulmonary valve leaflet augmentation for transannular repair of tetralogy of Fallot
| Autor: | Tom R. Karl, Michael Daley, Nelson Alphonso, Prem Venugopal, Ramana Rao V. Dhannapuneni, Robert N. Justo, Aditya Patukale, Kim Betts |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
Pulmonary and Respiratory Medicine
Male medicine.medical_specialty 030204 cardiovascular system & hematology Transplantation Autologous 03 medical and health sciences 0302 clinical medicine Double outlet right ventricle Interquartile range medicine.artery Pulmonary Valve Replacement medicine Pericardium Humans Cardiac Surgical Procedures Child Polytetrafluoroethylene Tetralogy of Fallot Retrospective Studies Bioprosthesis Pulmonary Valve business.industry Infant Prostheses and Implants medicine.disease Surgery medicine.anatomical_structure Treatment Outcome 030228 respiratory system Pulmonary valve Child Preschool Pulmonary valve stenosis Pulmonary artery Female Cardiology and Cardiovascular Medicine business Follow-Up Studies |
| Zdroj: | The Journal of thoracic and cardiovascular surgery. 162(5) |
| ISSN: | 1097-685X |
| Popis: | Objective To evaluate the midterm results of pulmonary valve leaflet augmentation in transannular repair of tetralogy of Fallot (TOF). Methods From 2007 to 2019, 131 patients underwent a transannular repair with pulmonary leaflet augmentation for TOF (n = 120) and double outlet right ventricle with pulmonary stenosis (n = 11). Patch material was expanded polytetrafluoroethylene (n = 76), glutaraldehyde-treated autologous pericardium (n = 47) and bovine pericardium (n = 8). Results Median age at repair was 8.9 months (interquartile range, 5.4-14.8). There was no operative mortality. Median follow-up was 6.25 years (interquartile range, 2.77-7.75). Freedom from severe pulmonary regurgitation (PR) was 85% (95% confidence interval [CI], 77%-90%) and 76% (95% CI, 66%-83%) at 1 and 5 years, respectively. Freedom from moderate or greater PR was 69% (95% CI, 60%-76%) and 30% (95% CI, 21%-39%) at 5 and 10 years, respectively. Three patients required pulmonary valve replacement for PR. Nine patients required pulmonary balloon valvuloplasty. Freedom from intervention for pulmonary valve stenosis was 98% (95% CI, 93%-99%) and 94% (95% CI, 87%-97%) at 1 and 5 years, respectively. One patient with severe PR had an indexed right ventricular volume >160 mL/m2. Use of expanded polytetrafluoroethylene resulted in a greater freedom from moderate or greater PR (log-rank test P Conclusions At midterm follow-up of transannular repair with pulmonary valve leaflet augmentation, severe PR occurs in less than 50% of patients. The expanded polytetrafluoroethylene patch performs better than pericardium. |
| Databáze: | OpenAIRE |
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