title: Pulmonary valve replacement late after repair of tetralogy of Fallot.
abstract: BACKGROUND
  Pulmonary valve incompetence is usually well tolerated after tetralogy of Fallot repair but may result in late progressive right heart failure as manifested by increasing fatigue, dyspnea, and frequently arrhythmias.
  
  
  METHODS
  All patients who underwent pulmonary valve replacement in our center late after repair of tetralogy of Fallot were reviewed.
  
  
  RESULTS
  Eighty-five patients had elective pulmonary valve replacement late (median, 9.3 years) after repair. Operative risk was low (1.1%). Ninety percent of survivors are in New York Heart Association class I. Survival 10 years after pulmonary valve replacement is 95%, with 86% of the patients free of reoperation for valve failure.
  
  
  CONCLUSIONS
  Pulmonary valve replacement is infrequently required after repair of tetralogy of Fallot. Pulmonary valve replacement may be performed electively with little risk; it improves symptoms of right heart failure and provides satisfactory long-term survival with low risk of early valve failure. As the population of patients who have had repair of tetralogy of Fallot ages, pulmonary valve replacement will become a more frequent consideration.
authors.affiliation: Hospital for Sick Children, Toronto, Ontario, Canada.
authors.forename: I M
authors.initials: IM
authors.lastname: Yemets
authors.forename: W G
authors.initials: WG
authors.lastname: Williams
authors.forename: G D
authors.initials: GD
authors.lastname: Webb
authors.forename: D A
authors.initials: DA
authors.lastname: Harrison
authors.forename: P R
authors.initials: PR
authors.lastname: McLaughlin
authors.forename: G A
authors.initials: GA
authors.lastname: Trusler
authors.forename: J G
authors.initials: JG
authors.lastname: Coles
authors.forename: I M
authors.initials: IM
authors.lastname: Rebeyka
authors.forename: R M
authors.initials: RM
authors.lastname: Freedom
mesh_terms: D000293:Adolescent; D000328:Adult; D002303:Cardiac Output, Low / Q000209:etiology; D002648:Child; D002675:Child, Preschool; D018572:Disease-Free Survival; D005260:Female; D006350:Heart Valve Prosthesis; D006801:Humans; D007223:Infant; D008297:Male; D011664:Pulmonary Valve / Q000601:surgery*; D011665:Pulmonary Valve Insufficiency / Q000150:complications / Q000601:surgery; D013771:Tetralogy of Fallot / Q000150:complications / Q000601:surgery*; D013997:Time Factors