title: [Right ventricular outflow tract reconstruction with PTFE mono-cusped transannular patch for tetralogy of Fallot].
abstract: Conotruncal repair for tetralogy of Fallot consists of (1) precise closure of the VSD with the membranous flap and (2) reconstruction of the right ventricular outflow tract (RVOT) by a short transannular patch (< 30% of the RV length) with a wide PTFE monocusp. This report describes the mid-term results in 46 patients with tetralogy of Fallot who underwent conotruncal repair with PTFE monocusped transannular patch and have been followed up for 4 years or more. There was no early and late death and no patient required reoperation. No patient has had a significant residual defect or tricuspid regurgitation (> II). The right and left ventricular pressure ratio was 0.41 +/- 0.12 and the pressure gradient across RVOT was 10.5 +/- 5.9 mmHg, signifying sufficient relief of RVOT obstruction. The mobility of the PTFE monocusp was echocardiographically detected in 86% over a mean follow-up period of 84 +/- 34 months and % freedom from pulmonary regurgitation (> II) was 85.9% at 10 years postoperatively. Excellent long-term durability of the PTFE monocusp provided the normal right vent performance with RVEDV of 91.8 +/- 29.5% of normal and a central venous pressure of 5 +/- 1 mmHg. In conclusion, conotruncal repair with a wide and short transannular patch has provided good mid-term results with the excellent long-term durability of PTFE monocusp.
authors.affiliation: Department of Cardiovascular Surgery, Jikei University School of Medicine, Tokyo, Japan.
authors.forename: K
authors.initials: K
authors.lastname: Morita
authors.forename: H
authors.initials: H
authors.lastname: Kurosawa
authors.forename: K
authors.initials: K
authors.lastname: Nomura
authors.forename: H
authors.initials: H
authors.lastname: Naganuma
authors.forename: H
authors.initials: H
authors.lastname: Matsumura
authors.forename: N
authors.initials: N
authors.lastname: Kawada
authors.forename: T
authors.initials: T
authors.lastname: Inoue
authors.forename: M
authors.initials: M
authors.lastname: Kinouchi
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D019918:Heart Valve Prosthesis Implantation; D006352:Heart Ventricles / Q000601:surgery; D006801:Humans; D007223:Infant; D008875:Middle Aged; D011138:Polytetrafluoroethylene; D011651:Pulmonary Artery / Q000601:surgery; D011665:Pulmonary Valve Insufficiency / Q000601:surgery; D019651:Plastic Surgery Procedures; D012189:Retrospective Studies; D013771:Tetralogy of Fallot / Q000503:physiopathology / Q000601:surgery*; D016276:Ventricular Function
chemical_list: D011138:Polytetrafluoroethylene