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Surgical pulmonary valve insertion – when, how, and why

Published online by Cambridge University Press:  18 January 2013

Cheul Lee ,
Jeffrey P. Jacobs ,
Chang-Ha Lee ,
Jae Gun Kwak ,
Paul J. Chai  and
James A. Quintessenza
Cheul Lee*
Affiliation:
Department of Thoracic and Cardiovascular Surgery, Cardiovascular Center, Sejong General Hospital, Bucheon, Republic of Korea
Jeffrey P. Jacobs
Affiliation:
Johns Hopkins Children's Heart Surgery, All Children's Hospital and Florida Hospital for Children, Saint Petersburg, Tampa, and Orlando, Florida, United States of America
Chang-Ha Lee
Affiliation:
Department of Thoracic and Cardiovascular Surgery, Cardiovascular Center, Sejong General Hospital, Bucheon, Republic of Korea
Jae Gun Kwak
Affiliation:
Department of Thoracic and Cardiovascular Surgery, Cardiovascular Center, Sejong General Hospital, Bucheon, Republic of Korea
Paul J. Chai
Affiliation:
Johns Hopkins Children's Heart Surgery, All Children's Hospital and Florida Hospital for Children, Saint Petersburg, Tampa, and Orlando, Florida, United States of America
James A. Quintessenza
Affiliation:
Johns Hopkins Children's Heart Surgery, All Children's Hospital and Florida Hospital for Children, Saint Petersburg, Tampa, and Orlando, Florida, United States of America
*
Correspondence to: Dr C. Lee, MD, PhD, Department of Thoracic and Cardiovascular Surgery, Cardiovascular Center, Sejong General Hospital, 91–121 Sosa Bon 2-dong, Sosa-gu, Bucheon, Gyeonggi-do 422–711, Republic of Korea. Tel: +82 32 340 1451; Fax: +82 32 340 1236; E-mail: tscheul@hanmail.net
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Abstract

Relief of right ventricular outflow tract obstruction in tetralogy of Fallot or similar physiology often results in pulmonary regurgitation. The resultant chronic volume overload can lead to right ventricular dilatation, biventricular dysfunction, heart failure symptoms, arrhythmias, and sudden death. Although pulmonary valve replacement can lead to improvement in functional class and a substantial decrease or normalisation of right ventricular volumes, the optimal timing of pulmonary valve replacement is not well defined. Benefits of pulmonary valve replacement have to be weighed against the risks of this procedure, including subsequent reoperation. This article will review the benefits and risks of pulmonary valve replacement, options for pulmonary valve substitute, and timing of pulmonary valve replacement in patients with chronic pulmonary regurgitation after relief of right ventricular outflow tract obstruction.

Keywords

Magnetic resonance imagingpulmonary regurgitationpulmonary valve replacementsurgerytetralogy of Fallot
Type
Original Article
Information
Cardiology in the Young , Volume 22 , Issue 6: A Lifelong Interdisciplinary Approach to Common Arterial Trunk, Transposition of the Great Arteries, and Other Evolving Challenges in Paediatric and Congenital Cardiac Disease , December 2012 , pp. 702 - 707
Copyright
Copyright © Cambridge University Press 2012

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