[Reoperation of tetralogy of Fallot for the transannular patch neo-intimal stenosis: a case report].
A 3-year-old male patient underwent right ventricular outflow tract reconstruction with a glutaraldehyde-preserved equine pericardium for tetralogy of Fallot. Because of progressive severe pulmonary restenosis with over systemic right ventricular pressure, tricuspid regurgitation, and abnormal high echoic shadow in the distal main pulmonary artery on echocardiogram, he required reoperation a year after the first correction. In the reoperative findings, the pseudointima was thickened heavily and detached from glutaraldehyde-preserved equine pericardial patch. The patch was removed and the right ventricular outflow was reconstructed widely to the pulmonary bifurcation with porcine pericardial patch again. Patho-histological findings showed foreign body giant cells and macrophages in the pseudointima. Four years after the reoperation, echocardiogram shows 41 mmHg for the right ventricular pressure and 22 mmHg for the pressure gradient of right ventricular outflow tract, and the patient is doing well now.
Ozawa
T
T
Department of Thoracic and Cardiovascular Surgery, Toho University School of Medicine, Tokyo, Japan.
Yoshihara
K
K
Koyama
N
N
Watanabe
Y
Y
Shiono
N
N
Fujii
T
T
Sakuragawa
H
H
Hamada
S
S
Masuhara
H
H
Takanashi
Y
Y
D006348:Cardiac Surgical Procedures / Q000379:methods; D002675:Child, Preschool; D006801:Humans; D008297:Male; D011138:Polytetrafluoroethylene; D011183:Postoperative Complications / Q000601:surgery*; D011666:Pulmonary Valve Stenosis / Q000209:etiology* / Q000601:surgery*; D012086:Reoperation; D013771:Tetralogy of Fallot / Q000473:pathology / Q000601:surgery*
D011138:Polytetrafluoroethylene