Surgical management of right ventricular dysfunction late after repair of tetralogy of fallot: right ventricular remodeling surgery

Seminars in Thoracic and Cardiovascular Surgery. Pediatric Cardiac Surgery Annual
Pedro J del Nido

Abstract

With the increasing number of late survivors of repair of tetralogy of Fallot, surgical management of patients with right ventricular (RV) dysfunction and limited exercise capacity has become a more frequent problem. The wide variability in clinical status, extent of RV dilatation, and dysfunction at the time of presentation for surgical intervention has resulted in disparate surgical results after pulmonary valve insertion. With increasing use of magnetic resonance imaging, quantitative measures of RV volumes, function, and pulmonary regurgitant fraction have enabled a more systematic analysis of results. While there is a group of patients that responds favorably to pulmonary valve insertion, there is also a large subgroup that does not; this requires further analysis of the mechanisms responsible. We have developed a surgical approach to this latter group of patients, which incorporates the concepts of ventricular remodeling or restoration developed for the left ventricle following myocardial infarction. Preliminary results indicate that this procedure is equally safe to pulmonary valve insertion alone, and may result in improved RV function.

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Citations

Jan 22, 2010·World Journal of Surgery·Joanne P Starr
Mar 20, 2013·The Journal of Thoracic and Cardiovascular Surgery·Heiner LatusChristian Apitz
May 9, 2012·The Annals of Thoracic Surgery·Sarosh P BatlivalaDoff B McElhinney
Apr 8, 2009·Seminars in Thoracic and Cardiovascular Surgery. Pediatric Cardiac Surgery Annual·Massimo A PadalinoGiovanni Stellin
Apr 17, 2007·Seminars in Thoracic and Cardiovascular Surgery. Pediatric Cardiac Surgery Annual·Robert H AndersonPaul P Lunkenheimer
Apr 17, 2007·Seminars in Thoracic and Cardiovascular Surgery. Pediatric Cardiac Surgery Annual·Erle H Austin
Oct 25, 2006·The Journal of Thoracic and Cardiovascular Surgery·Robert H Anderson, Paul P Lunkenheimer
Apr 1, 2008·Congenital Heart Disease·Denise JoffeKaren Stout
Apr 3, 2009·European Journal of Echocardiography : the Journal of the Working Group on Echocardiography of the European Society of Cardiology·Katarina ZervanUlrike Salzer-Muhar
May 23, 2012·Journal of Cardiovascular Medicine·Massimo A PadalinoGiovanni Stellin
Jun 29, 2018·Frontiers in Pediatrics·Antonio F Corno
May 1, 2017·Nano Reviews & Experiments·Antonio F CornoSimone Speggiorin
Apr 22, 2021·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·Marien LenoirLoïc Macé

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