title: Use of a pulmonary neovalve with a transannular patch for repair of tetralogy of fallot.
abstract: OBJECTIVE
  To report on our initial experience with the implantation of a pulmonary valve using Nunn's technique in association with a transannular patch for the complete repair of the tetralogy of Fallot.
  
  
  METHODS
  In total, 21 patients were treated between September 2008 and February 2010. Their ages ranged from 7 months to 15 years (median 12 months) and weights from 6.8 kg to 44 kg (median 10 kg). Four patients had previously undergone palliative shunt placement; in two, it was associated with the diagnosis of a complete atrioventricular septal defect. Use of the transannular patch (treated autologous pericardium) was preceded by implantation of a 0.1-mm polytetrafluoroethylene (PTFE) monocusp valve using posterior fixation. Intraoperative transesophageal echocardiography and pressure gradient measurement were carried out, and echocardiography was repeated before discharge.
  
  
  RESULTS
  No deaths were recorded. One patient had a residual ventricular septal defect that required reintervention. Echocardiography showed that the maximum gradient across the PTFE valve was 25 mmHg. Regurgitation was mild in 19 cases and moderate in 2 (the first and second in the series).
  
  
  CONCLUSIONS
  Initial results using a transannular patch with a modified monocusp valve to repair the outflow tract in the tetralogy of Fallot were promising: there was only a slight pressure gradient and mild regurgitation. A medium-or long-term follow-up study is required to confirm these findings and to compare them with results obtained using other techniques.
authors.affiliation: Hospital Materno-Infantil Carlos Haya, Málaga, España. giljaurena@gmail.com
authors.forename: Juan-Miguel
authors.initials: JM
authors.lastname: Gil-Jaurena
authors.forename: Manuel
authors.initials: M
authors.lastname: Ferreiros
authors.forename: Rafael
authors.initials: R
authors.lastname: Castillo
authors.forename: Lourdes
authors.initials: L
authors.lastname: Conejo
authors.forename: Victorio
authors.initials: V
authors.lastname: Cuenca
authors.forename: Juan-Ignacio
authors.initials: JI
authors.lastname: Zabala
mesh_terms: D000293:Adolescent; D006348:Cardiac Surgical Procedures / Q000379:methods; D002648:Child; D002675:Child, Preschool; D017548:Echocardiography, Transesophageal; D005260:Female; D006344:Heart Septal Defects, Atrial / Q000601:surgery; D006350:Heart Valve Prosthesis; D019918:Heart Valve Prosthesis Implantation; D006801:Humans; D007223:Infant; D008297:Male; D016343:Monitoring, Intraoperative; D011138:Polytetrafluoroethylene; D011664:Pulmonary Valve / Q000601:surgery*; D013771:Tetralogy of Fallot / Q000601:surgery*
chemical_list: D011138:Polytetrafluoroethylene