[Single cusp homograft implantation in the reconstruction of right ventricular outflow tract in the correction of tetralogy of Fallot].
From 1987 to 1990, 37 children underwent surgical correction for tetralogy of Fallot. The mean age was 38.2 months (2-156 months). The indication for right ventricular outflow tract (RVOT) obstruction in 19/37 (51%) children was: hypoplastic pulmonary valve (n = 10), annular hypoplasia (n = 12), RVOT obstruction and hypoplastic pulmonary artery (n = 10). In 18/37 (49%) children, the repair of the RVOT was done without homograft. The RVOT morphology was the only indication for reconstruction with homograft. All other pre-, intra- and postoperative data were identical for both groups. There was no operative or late death. After a mean follow-up of 4.4 months, all 19 children with homograft were in NYHA class I and echocardiographic evaluation showed mild and moderate pulmonary regurgitation in 8 and 4 children respectively. Out of the 18 children without homograft, 16 were in NYHA class I and 2 in NYHA class II. Two children had early postoperative right heart failure. The mean follow-up time in this group was 5.5 months. Echocardiography revealed residual pulmonary regurgitation in 4 children, pulmonary stenosis in 6 and combined residual pulmonary valve defect in 6. If severe malformation of the RVOT or the pulmonary artery is present, a valved homograft is recommended for repair of tetralogy of Fallot. Good morphological and functional results may be achieved.
Vogt
P R
PR
Klinik für Herz- und Gefässchirurgie, Universitätsspital Zürich.
Bauer
E P
EP
von Segesser
L K
LK
Turina
M I
MI
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D004452:Echocardiography; D005260:Female; D006350:Heart Valve Prosthesis; D006801:Humans; D007223:Infant; D008297:Male; D011664:Pulmonary Valve / Q000601:surgery*; D011665:Pulmonary Valve Insufficiency / Q000601:surgery; D013771:Tetralogy of Fallot / Q000150:complications / Q000601:surgery*; D014184:Transplantation, Homologous; D014694:Ventricular Outflow Obstruction / Q000150:complications / Q000601:surgery*
Homograft-Monocusp-Implantation zur Rekonstruktion des rechtsventrikulären Ausflusstraktes bei der Korrektur der Fallot-Tetralogie.