title: Pulmonary valve repair late after right ventricular outflow tract reconstruction in children and adolescents.
abstract: Here, we report our experience with pulmonary valve (PV) repair using neoleaflet implantation in children and adolescents. Between April 2005 and May 2009, 20 patients underwent late PV repair with neoleaflet implantation for pulmonary regurgitation (PR) after reconstruction of the right ventricular outflow tract at <18 years of age. In patients with sufficient remaining native PV leaflets, the neoleaflet was implanted with a polytetrafluoroethylene membrane or fresh autologous pericardium to coapt with the remaining native PV leaflets. The median age at operation was 13 years (2-18 years). The median follow-up duration was 12 months (2-51 months). There was no early or late death. During follow-up, no significant PR was observed, but significant pulmonary stenosis (PS) developed in two patients who had a combined PS. The indexed right ventricular end diastolic dimension decreased during follow-up. At the latest follow-up, all patients were in New York Heart Association functional class I or II. PV repair with neoleaflet implantation can be performed safely and the outcome is satisfactory in the short-term, but attention must be paid in cases with combined PS. Longer follow-up should be carried out to investigate the changes in leaflet mobility and function, and pulmonary annular growth.
authors.affiliation: Department of Thoracic and Cardiovascular Surgery, Sejong General Hospital, Seoul, South Korea.
authors.forename: Chun Soo
authors.initials: CS
authors.lastname: Park
authors.forename: Chang-Ha
authors.initials: CH
authors.lastname: Lee
authors.forename: Young Ok
authors.initials: YO
authors.lastname: Lee
authors.forename: Gi-Beom
authors.initials: GB
authors.lastname: Kim
authors.forename: Jin-Tae
authors.initials: JT
authors.lastname: Kim
authors.forename: Yong Jin
authors.initials: YJ
authors.lastname: Kim
mesh_terms: D000293:Adolescent; D006348:Cardiac Surgical Procedures / Q000009:adverse effects*; D002648:Child; D002675:Child, Preschool; D015150:Echocardiography, Doppler; D006330:Heart Defects, Congenital / Q000601:surgery*; D006350:Heart Valve Prosthesis; D019918:Heart Valve Prosthesis Implantation / Q000009:adverse effects / Q000295:instrumentation; D006801:Humans; D008567:Membranes, Artificial; D010496:Pericardium / Q000637:transplantation; D011138:Polytetrafluoroethylene; D011474:Prosthesis Design; D011664:Pulmonary Valve / Q000503:physiopathology / Q000601:surgery*; D011665:Pulmonary Valve Insufficiency / Q000209:etiology / Q000503:physiopathology / Q000601:surgery*; D011666:Pulmonary Valve Stenosis / Q000209:etiology* / Q000503:physiopathology / Q000601:surgery*; D012189:Retrospective Studies; D013997:Time Factors; D014182:Transplantation, Autologous; D016896:Treatment Outcome
chemical_list: D008567:Membranes, Artificial; D011138:Polytetrafluoroethylene