Published online by Cambridge University Press: 09 January 2014
Pulmonary valve replacement is being performed with increasing frequency in patients with various congenital heart diseases. Chronic pulmonary regurgitation after repair of tetralogy of Fallot is a typical situation that requires pulmonary valve replacement. Chronic pulmonary regurgitation after repair of tetralogy of Fallot 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 in patients with chronic pulmonary regurgitation is still unknown. There are several options for surgical pulmonary valve replacement. However, no ideal pulmonary valve substitute exists currently and most of the surgically implanted pulmonary valves will eventually require re-replacement. This article will review options and timing of surgical pulmonary valve insertion in patients with chronic pulmonary regurgitation after repair of tetralogy of Fallot.
Presented at “The Birth of Heart Surgery: Lessons Learned from Tetralogy – Past, Present and Future” Dinner Symposium Sponsored by Johns Hopkins Medicine and All Children's Hospital, Thursday, February 21, 2013, at The Sixth World Congress of Paediatric Cardiology and Cardiac Surgery, Cape Town International Convention Centre, Cape Town, South Africa, February 17–22, 2013. A video of this presentation can be viewed at the following hyperlink: [http://www.allkids.org/wcpccs].