RVOT RECONSTRUCTION STRATEGIES IN TOF: SINGLE CENTER EXPERIENCE
Main Article Content
Keywords
tetralogy of fallot, mono cusp, right atrial appendage
Abstract
Introduction:. While dealing with right ventricular outflow tract in TOF , pulmonary regurgitation due to pulmonary valve dysfunction is common. When the pulmonary valve cannot be preserved, 11 some sort of pulmonary reconstruction is required to prevent pulmonary regurgitation. The strategies to reconstruct pulmonary valve include creation of mono cusp valve, either with autologous pericardium, bovine jugular vein mono cusp valve or poly tetra fluoroethylene ( PTFE). More recently, right atrial appendage has been used to reconstruct pulmonary valve.
Patients and methods: All the data was retrieved from data base. Data of all patients who underwent complete repair of tetralogy of Fallot’s from January 2019 to December 2023 ( 5 years) at Children’s Hospital Lahore/ university of Child Health Sciences Lahore. Different techniques to preserve/reconstruct pulmonary valve were studied. Primary endpoint of interest was in hospital mortality.
Results: 841 underwent complete repair for tetralogy of Fallot’s. Mean age of the patients was 2.9 years and mean weight was 9.1 Kg. in 179 patients, pulmonary valve was preserved (21 %). Trans annular patch with mono cusp valve was used in 605 patients. PTFE mono cusp was used in 164, and autologous untreated pericardial mono cusp was used in 441 patients..
Conclusions: Efforts should be made to preserve pulmonary valve in tetralogy of fallot’s surgery but if valve sparing is not possible, there are variety of techniques to reconstruct right ventricular outflow tract which can be used to prevent pulmonary regurgitation and its deleterious effects in peri operative period
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Dr Faiz Rasool
Associate professor pediatric cardiac surgery children hospital Lahore, MBBS FCPS MEBCTS FEBCTS
Dr. Asim khan
Professor of pediatruc cardiac surgery children hospital Lahore
Dr. Salman shah
Professor of pediatric cardiac surgery children hospital Lahore
Dr. Syed sardar Rahim
Denior registrar pediatric cardiac surgery children hospital Lahore
Dr. Ghulam Kibria
Senior registrar children hospital Lahore
Dr. Tehmina Kazmi
Associate professor pediatric cardiology children hospital Lahore