Correction of tetralogy of fallot with absent pulmonary valve syndrome in a young infant using a bicuspid equine pericardial tube.
Absent pulmonary valve syndrome (APVS) is an uncommon variant of tetralogy of Fallot (TOF), which manifests morphologically as vestigial pulmonary valve cusps at the right ventricle-pulmonary trunk junction. The aneurysmally dilated pulmonary arteries may compress the tracheobronchial tree and cause severe respiratory distress in the neonatal or infant stage. Early surgical correction in these patients is necessary despite the high operative mortality rate. A 1-day-old male neonate suffered from progressive shortness of breath after birth. Echocardiography confirmed the diagnosis of TOF with APVS. The marked dilatation of pulmonary arteries resulted in airway compression in addition to heart failure. Total surgical correction was performed at 40 days of age, using a homemade bicuspid equine pericardial tube for right ventricular outflow reconstruction. The short-term follow-up echocardiogram demonstrated good motility of the pericardial leaflet. However, patients receiving this type of valved conduit require meticulous long-term follow-up.
Roan
Jun-Neng
JN
Division of Cardiovascular Surgery, Department of Surgery, National Cheng Kung University Hospital, Tainan, Taiwan.
Lai
Chao-Han
CH
Wen
Jih-Sheng
JS
Lin
Pao-Yen
PY
Luo
Chwan-Yau
CY
Wu
Jing-Ming
JM
Yang
Yu-Jen
YJ
D006348:Cardiac Surgical Procedures / Q000379:methods; D019918:Heart Valve Prosthesis Implantation; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D011664:Pulmonary Valve / Q000002:abnormalities* / Q000601:surgery*; D013577:Syndrome; D013771:Tetralogy of Fallot / Q000601:surgery*