Korean Journal of Pediatrics 2006;49(6):635-642.
Published online June 15, 2006.
Early and mid-term results of pulmonary valve reconstruction in surgical repair of tetralogy of Fallot; comparison with other techniques of right ventricular outflow reconstruction
Sheng Wen Wang1, Young Seok Lee1, Si Ho Kim2, Tae Hong Kim3, Ji Eun Ban4, Hyoung Doo Lee4, Yun Hee Chang5, Si Chan Sung5
1Department of Pediatrics, College of Medicine, Dong-A University, Busan
2Department of Cardiovascular Surgery, College of Medicine, Dong-A University, Busan
3Department of Pediatrics, Masan Samsung Hospital, Sungkyunkwan University School of Medicine, Masan
4Department of Pediatrics, College of Medicine, Pusan National University, Busan, Korea
5Department of Cardiovascular Surgery, College of Medicine, Pusan National University, Busan, Korea
활로사징 완전교정술에서 폐동맥 판막 재건술의 조기 및 중기 결과; 우심실 유출로 재건 방법에 따른 비교
왕승문1, 이영석1, 김시호2, 김태홍3, 반지은4, 이형두4, 장윤희5, 선시찬5
1동아대학교 의과대학 소아과학교실
2동아대학교 의과대학 흉부외과학교실
3성균관대학교 의과대학 마산삼성병원 소아과
4부산대학교 의과대학 소아과학교실
5부산대학교 의과대학 흉부외과학교실
Correspondence: 
Young Seok Lee, Email: lyspedia@dau.ac.kr
Abstract
Purpose
: The purpose of this study is to determine whether the new pulmonary valve reconstruction technique prevents short-term postoperative pulmonary regurgitation and improves early and mid-term clinical outcome.
Methods
: We reviewed postoperative echocardiographic variables and chest X-ray films from 31 patients who had undergone valve reconstruction(pulmonary valve reconstruction group : PVR) for the repair of TOF between April 2000 and August 2004. We compared the clinical data of these patients with those from 47 patients who had right ventricular outflow tract reconstruction with a monocusp valve(monocusp ventricular outflow patch group : MVOP) and 22 patients who had a transannular patch repair without a monocusp valve(transannular patch group : TAP).
Results
: In the PVR group, 25 patients(81 percent) had trivial or mild pulmonary regurgitation in their early post operative echocardiogram. Only 12 patients(26 percent) in the MVOP group had mild pulmonary regurgitation; and no patient in the TAP group had it. Pulmonary valve function was good in 96 percent of the PVR group, 36 percent of the MVOP group, and none in the TAP group in early post-operative echocardiogram. Follow-up echocardiogram(1, 2, 3, 4 years later) of the MVOP and TAP groups showed moderate pulmonary regurgitation and severely decreased valve function in almost all cases. However, in the PVR group 54 percent(16/28), 50 percent(14/28), 37 percent(9/24), and 31 percent(5/16) of the patients had trivial or mild pulmonary regurgitation 1, 2, 3 and 4 years after operation, respectively. The valve function remained good in 80 percent(24/30), 64 percent(18/28), 57 percent(12/21), and 31 percent(5/16) of the patients 1, 2, 3 and 4 years after operation respectively.
Conclusion
: Pulmonary valve reconstruction is effective in reducing pulmonary regurgitation and right ventricular dilatation in the repair of TOF, even though regurgitation increases with time. Further study is needed to determine long-term results.
Key Words: Tetralogy of Fallot , Pulmonary regurgitation , Pulmonary valve reconstruction


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