title: Pulmonary valve replacement in adults with repaired tetralogy of Fallot.
abstract: There is a growing population of young adults with tetralogy of Fallot. Although surgical approaches have evolved, many adults with repaired tetralogy of Fallot have been left with residual pulmonary regurgitation. Pulmonary regurgitation is an important contributor to a number of late complications including exercise limitations, right heart failure, arrhythmia, and sudden death. Because bioprosthetic valves are used in this population, clinicians must weigh the beneficial effects of pulmonary valve replacement against the associated risks, including subsequent re-operation. In this review, we will appraise the evidence supporting pulmonary valve replacement in the adult with repaired tetralogy of Fallot, as well as the optimal timing and mode of intervention.
authors: University of Toronto, Toronto Congenital Cardiac Centre for Adults, Peter Munk Cardiac Centre, University Health Network, Toronto, Canada.
authors: Luke J
authors: LJ
authors: Burchill
authors: Rachel M
authors: RM
authors: Wald
authors: Louise
authors: L
authors: Harris
authors: Jack M
authors: JM
authors: Colman
authors: Candice K
authors: CK
authors: Silversides
mesh_terms: D000328:Adult; D000367:Age Factors; D006348:Cardiac Surgical Procedures / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D019918:Heart Valve Prosthesis Implantation / Q000379:methods*; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D011183:Postoperative Complications / Q000401:mortality / Q000503:physiopathology; D011665:Pulmonary Valve Insufficiency / Q000175:diagnosis / Q000601:surgery*; D012086:Reoperation / Q000379:methods; D018570:Risk Assessment; D015996:Survival Rate; D013771:Tetralogy of Fallot / Q000175:diagnosis / Q000601:surgery*; D016896:Treatment Outcome; D055815:Young Adult