Postsurgery of Tetralogy of Fallot, Aneurysm of the Right Ventricular Outflow Tract, and Branch Pulmonary Insufficiency

2015 ◽  
pp. 245-248
Author(s):  
Hakimeh Sadeghian ◽  
Zahra Savand-Roomi
Keyword(s):  
Right Ventricular ◽  
Tetralogy Of Fallot ◽  
Right Ventricular Outflow Tract ◽  
Ventricular Outflow Tract ◽  
Outflow Tract ◽  
Pulmonary Insufficiency ◽  
The Right

The current strategy of repair of tetralogy of Fallot in children and adults

2008 ◽  
Vol 18 (6) ◽  
pp. 608-614 ◽  
Author(s):  
Guo-Wei He ◽  
Xiao-Cheng Liu ◽  
Xiang-Rong Kong ◽  
Li-Xin Liu ◽  
Ying-Qun Yan ◽  
...  
Keyword(s):  
Right Ventricular ◽  
Tetralogy Of Fallot ◽  
Right Ventricular Function ◽  
Right Atrium ◽  
Pulmonary Valve ◽  
Right Ventricular Outflow Tract ◽  
Ventricular Outflow Tract ◽  
Outflow Tract ◽  
Pulmonary Insufficiency ◽  
The Right

AbstractObjectivesThe strategies of repair of tetralogy of Fallot change with the age of patients. In children older than 4 years and adults, the optimal strategy may be to use different method of reconstruction of the right ventricular outflow tract from those followed in younger children, so as to avoid, or reduce, the pulmonary insufficiency that is increasingly known to compromise right ventricular function.MethodsFrom April, 2001, through May, 2008, we undertook complete repair in 312 patients, 180 male and 132 female, with a mean age of 11.3 years ±0.4 years, and a range from 4 to 48 years, with typical clinical and morphological features of tetralogy of Fallot, including 42 patients with the ventriculo-arterial connection of double outlet right ventricle. The operation was performed under moderate hypothermia using blood cardioplegia. The ventricular septal defect was closed with a Dacron patch. When it was considered necessary to resect the musculature within the right ventricular outflow tract, or perform pulmonary valvotomy, we sought to preserve the function of the pulmonary valve by protecting as far as possible the native leaflets, or creating a folded monocusp of autologous pericardium.ResultsThe repair was achieved completely through right atrium in 192, through the right ventricular outflow tract in 83, and through the right atrium, the outflow tract, and the pulmonary trunk in 36 patients. A transjunctional patch was inserted in 169 patients, non-valved in all but 9. There were no differences regarding the periods of aortic cross-clamping or cardiopulmonary bypass. Of the patients, 5 died (1.6%), with no influence noted for the transjunctional patch. Of those having a non-valved patch inserted, three-tenths had pulmonary regurgitation of various degree, while those having a valved patch had minimal pulmonary insufficiency and good right ventricular function postoperatively, this being maintained after follow-up of 8 to 24-months.ConclusionsBased on our experience, we suggest that the current strategy of repair of tetralogy of Fallot in older children and adults should be based on minimizing the insertion of transjunctional patches, this being indicated only in those with very small ventriculo-pulmonary junctions. If such a patch is necessary, then steps should be taken to preserve the function of the pulmonary valve.

Late replacement of the pulmonary valve: when and what type of valve?

2005 ◽  
Vol 15 (S1) ◽  
pp. 58-63 ◽  
Author(s):  
James A. Quintessenza ◽  
Jeffrey P. Jacobs ◽  
Paul J. Chai ◽  
Victor O. Morell ◽  
Jorge M. Giroud ◽  
...  
Keyword(s):  
Right Ventricular ◽  
Tetralogy Of Fallot ◽  
Pulmonary Valve ◽  
Right Ventricular Outflow Tract ◽  
Ventricular Outflow Tract ◽  
Outflow Tract ◽  
Pulmonary Insufficiency ◽  
Operative Strategy ◽  
Surgical Options ◽  
The Right

After repair of tetralogy of Fallot, many patients present in need of reoperative surgical reconstruction of the right ventricular outflow tract. The predominant physiologic lesion is pulmonary insufficiency, but there may also be varying degrees of obstruction of the right ventricular outflow tract. In the past, it has been felt that patients tolerate pulmonary insufficiency reasonably well. In some patients, however, the long-term effects of pulmonary insufficiency and subsequent right ventricular dilation and dysfunction are associated with poor exercise tolerance and increased incidence of arrhythmias and sudden death.1,2 Numerous studies support replacement of the pulmonary valve as treatment for pulmonary insufficiency in order to improve performance, optimize hemodynamics, and better control arrhythmias.3–10 The indications for reconstruction of the right ventricular outflow tract in this setting, nonetheless, as well as the operative strategy, continue to evolve. There are multiple surgical options for replacement of the pulmonary valve for these patients, including aortic and pulmonary homografts, stented and stentless porcine valves, porcine valved conduits, bovine jugular venous conduits, and even mechanical valves and mechanical valved conduits.11–32 It was a less than ideal experience with these currently available options that stimulated our interest into employing alternative materials and techniques. Favorable experimental and clinical experience with valves made of a polytetrafluoroethylene monoleaflet33–36 encouraged us to consider a new method of reconstruction with this material, using a bifoliate polytetrafluoroethylene valve. In this work, we review our indications for replacement of the pulmonary valve after repair of tetralogy of Fallot, the surgical options available, and our experience reconstructing the right ventricular outflow tract with a new surgically created bifoliate polytetrafluoroethylene valve.

Giant pseudo-aneurysm of the right ventricular outflow tract after Tetralogy of Fallot repair

2019 ◽  
Vol 30 (9) ◽  
pp. 1332-1334
Author(s):  
João Rato ◽  
Rita Ataíde ◽  
Ana Teixeira
Keyword(s):  
Right Ventricular ◽  
Tetralogy Of Fallot ◽  
Right Ventricular Outflow Tract ◽  
Ventricular Outflow Tract ◽  
Outflow Tract ◽  
Surgical Correction ◽  
Pseudo Aneurysm ◽  
The Right ◽  
Tetralogy Of Fallot Repair

AbstractImages of the diagnosis and correction of a pseudo-aneurysm at the right ventricular outflow tract, one of the rarest complications of Tetralogy of Fallot surgical correction.

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