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A Journal on Surgery
Indexed/Abstracted in: EMBASE, Scopus, Emerging Sources Citation Index
Chirurgia 2014 December;27(6):333-7
Pulmonary homografts in reoperations of Tetralogy of Fallot
Tasar M. 1, Eyileten Z. 1, Ozdem T. 1, Sayin T. 2, Odek C. 3, Ucar T. 4, Uysalel A. 1
1 Pediatric Cardiovascular Surgery Department, Ankara University School of Medicine, Ankara, Turkey;
2 Cardiology Department, Ankara University School of Medicine, Ankara, Turkey;
3 Pediatric Intensive Care Department, Ankara University School of Medicine, Ankara, Turkey;
4 Pediatric Cardiology, Ankara University, School of Medicine, Ankara, Turkey
AIM: We evaluated the outcomes of reoperations due to pulmonary homograft implantation to right ventricular outflow tract (RVOT) after total correction of Tetralogy of Fallot (TOF).
METHODS: Between March 2009 and January 2014, 9 patients underwent reoperation for pulmonary valve insufficiency as a late complication of total correction of TOF. Homografts were preserved in our own homograft bank.
RESULTS: The mean age was 16.33±9.88 (range 3-33). The median time between total correction and reoperation was 14.55±9.22 years (range 2-30). All patients had significant pulmonary valve insufficiency requiring surgery. There was no surgery-related morbidity or mortality. Mean Intensive Care Unit stay-time was 3 days and hospital stay time was 8 days after reoperation. There was no statistically significant differences between preoperative and postoperative ejection fraction values (55.5% vs. 58.9%). Three patients (33.3%) had minimal pulmonary insufficiency (PI), 1 (11.1%) patient had moderate PI.
CONCLUSION: Although total correction is the mainstay of treatment, late complications after previous surgery requiring reinterventions are not rare in TOF patients. Pulmonary valve insufficiency is one of the late complication of TOF and when surgery is not evitable, pulmonary homograft implantation to RVOT is a very useful choice with acceptable surgical results.