Surgical Results of Monocusp Implantation with Transannular Patch Angioplasty in Tetralogy of Fallot Repair.
10.5090/kjtcs.2016.49.5.344
- Author:
Woo Sung JANG
1
;
Joon Yong CHO
;
Jong Uk LEE
;
Youngok LEE
Author Information
1. Department of Thoracic and Cardiovascular Surgery, Kyungpook National University Hospital, Kyungpook National University School of Medicine, Korea. jycho@knu.ac.kr
- Publication Type:Original Article
- Keywords:
Tetralogy of Fallot;
Transannular patch;
Monocusp reconstruction
- MeSH:
Angioplasty*;
Echocardiography;
Follow-Up Studies;
Hemodynamics;
Humans;
Hypertension;
Incidence;
Postoperative Period;
Pulmonary Valve;
Pulmonary Valve Insufficiency;
Pulmonary Valve Stenosis;
Residual Volume;
Tetralogy of Fallot*
- From:The Korean Journal of Thoracic and Cardiovascular Surgery
2016;49(5):344-349
- CountryRepublic of Korea
- Language:English
-
Abstract:
BACKGROUND: Monocusp reconstruction with a transannular patch (TAP) results in early improvement because it relieves residual volume hypertension during the immediate postoperative period. However, few reports have assessed the long-term surgical outcomes of this procedure. The purpose of the present study was to evaluate the mid-term surgical outcomes of tetralogy of Fallot (TOF) repair using monocusp reconstruction with a TAP. METHODS: Between March 2000 and March 2009, 36 patients with a TOF received a TAP. A TAP with monocusp reconstruction (group I) was used in 25 patients and a TAP without monocusp reconstruction (group II) was used in 11 patients. We evaluated hemodynamic parameters using echocardiography during the follow-up period in both groups. RESULTS: At the most recent follow-up echocardiography (mean follow-up, 8.2 years), the mean pulmonary valve velocities of the patients in group I and group II were 2.1±1.0 m/sec and 0.9±0.9 m/sec, respectively (p=0.001). Although the incidence of grade 3–4 pulmonary regurgitation (PR) was not significantly different between the two groups (group I: 16 patients, 64.0%; group II: 7 patients, 70.0%; p=0.735) during the follow-up period, the interval between the treatment and the incidence of PR aggravation was longer in group I than in group II (group I: 6.5±3.4 years; group II: 3.8±2.2 years; p=0.037). CONCLUSION: Monocusp reconstruction with a TAP prolonged the interval between the initial treatment and grade 3–4 PR aggravation. Patients who received a TAP with monocusp reconstruction to repair TOF were not to progress to pulmonary stenosis during the follow-up period as those who received a TAP without monocusp reconstruction.
