Consequences of a selective approach toward pulmonary valve replacement in adult patients with tetralogy of Fallot and pulmonary regurgitation

The Journal of Thoracic and Cardiovascular Surgery
Folkert J MeijboomAd J J C Bogers

Abstract

The aim of the study was to assess the long-term results of a selective policy toward pulmonary valve replacement in adult patients with repaired tetralogy of Fallot and severe pulmonary regurgitation. Sixty-seven patients with tetralogy of Fallot were followed up from 15 +/- 3 years until 27 +/- 3 years after surgery. Twenty-two patients had mild-to-moderate pulmonary regurgitation. No significant changes occurred in the follow-up period. Of 45 patients with severe pulmonary regurgitation and severe right ventricular dilatation, 28 (62%) remained free of symptoms and did not undergo pulmonary valve replacement. No changes in right ventricular size or exercise capacity were found. In 3 (11%) of 28 patients, QRS duration increased to more than 180 ms. Seventeen patients had symptoms and underwent pulmonary valve replacement: 9 (54%) of 17 patients improved clinically and echocardiographically, and QRS duration shortened postoperatively. Right ventricular dimensions did not regress despite pulmonary valve replacement in 8 patients. Refraining from pulmonary valve replacement in asymptomatic patients led to no measurable deterioration in 25 (89%) of 28 patients. Referring symptomatic patients for pulmonary valve replacement led to...Continue Reading

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Citations

Jan 22, 2011·Journal of Cardiovascular Magnetic Resonance : Official Journal of the Society for Cardiovascular Magnetic Resonance·Tal Geva
Jul 1, 2008·Annals of Pediatric Cardiology·Tom R Karl
Aug 11, 2012·The Korean Journal of Thoracic and Cardiovascular Surgery·Tom R Karl
Nov 30, 2013·European Heart Journal Cardiovascular Imaging·Myrthe E MentingJolien W Roos-Hesselink
Aug 10, 2010·The American Journal of Cardiology·Eddie Wai-Yin CheungYiu-Fai Cheung
Oct 2, 2013·Journal of the American College of Cardiology·Paulo Ernando Ferraz CavalcantiRicardo de Carvalho Lima
Nov 20, 2008·Journal of the American College of Cardiology·Thomas P Graham
Oct 25, 2014·Circulation·Judith A A E CuypersJolien W Roos-Hesselink
Nov 28, 2019·Cardiology in the Young·Phillip M ZegelboneAllen D Everett
Mar 20, 2020·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·Jamie L R RomeoM Mostafa Mokhles
Sep 22, 2009·Expert Review of Cardiovascular Therapy·Thomas OosterhofBarbara J M Mulder
May 20, 2021·The International Journal of Cardiovascular Imaging·Daniel J BowenAnnemien E van den Bosch

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