Recycling of the pulmonary valve: an elegant solution for secondary pulmonary regurgitation in patients with tetralogy of Fallot.

Details

Serval ID
serval:BIB_B3BD158FDB75
Type
Article: article from journal or magazin.
Collection
Publications
Title
Recycling of the pulmonary valve: an elegant solution for secondary pulmonary regurgitation in patients with tetralogy of Fallot.
Journal
Annals of Thoracic Surgery
Author(s)
Prêtre R., Rosser B., Mueller C., Kretschmar O., Dave H.
ISSN
1552-6259 (Electronic)
ISSN-L
0003-4975
Publication state
Published
Issued date
2012
Peer-reviewed
Oui
Volume
94
Number
3
Pages
850-852
Language
english
Abstract
BACKGROUND: The purpose of this study was to review our experience with recycling of the pulmonary valve in cases of chronic pulmonary insufficiency after a transannular patch procedure as part of a repair of tetralogy of Fallot.
METHODS: Eight patients in whom the technique was used were reviewed. Technically, the valve was reapproximated at the anterior commissure if the valve leaflet was sufficiently developed and of good tissue quality. Additional corrections were performed in 5 patients (resection of an infundibular aneurysm [5 patients], repair of the tricuspid valve [1 patient]).
RESULTS: The valve was competent with no or trivial regurgitation in 5 patients and a small regurgitation in 3 patients. There was no significant transvalvular gradient in 5 patients with tricuspid valves and a small gradient in 3 patients with a bicuspid valves (<23 mm Hg). The valve function remained stable over the follow-up period (median time, 32 months).
CONCLUSIONS: Recycling of the pulmonary valve is an interesting concept that could avoid the necessary reoperations linked with valves or valved prostheses. The repair must be carefully followed in bicuspid valves because of a reduction in the opening area. Valve leaflets of good quality should be preserved during the primary repair of tetralogy of Fallot and the transannular incision should be made across the anterior commissure if possible. These steps should allow a few patients to profit from a recycling of their valves in the future.
Pubmed
Web of science
Create date
16/12/2014 18:53
Last modification date
20/08/2019 15:22
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