title: Surgical pulmonary valve insertion--when, how, and why.
abstract: Relief of right ventricular outflow tract obstruction in tetralogy of Fallot or similar physiology often results in pulmonary regurgitation. The resultant chronic volume overload can lead to right ventricular dilatation, biventricular dysfunction, heart failure symptoms, arrhythmias, and sudden death. Although pulmonary valve replacement can lead to improvement in functional class and a substantial decrease or normalisation of right ventricular volumes, the optimal timing of pulmonary valve replacement is not well defined. Benefits of pulmonary valve replacement have to be weighed against the risks of this procedure, including subsequent reoperation. This article will review the benefits and risks of pulmonary valve replacement, options for pulmonary valve substitute, and timing of pulmonary valve replacement in patients with chronic pulmonary regurgitation after relief of right ventricular outflow tract obstruction.
authors: Department of Thoracic and Cardiovascular Surgery, Cardiovascular Center, Sejong General Hospital, Bucheon, Republic of Korea. tscheul@hanmail.net
authors: Cheul
authors: C
authors: Lee
authors: Jeffrey P
authors: JP
authors: Jacobs
authors: Chang-Ha
authors: CH
authors: Lee
authors: Jae Gun
authors: JG
authors: Kwak
authors: Paul J
authors: PJ
authors: Chai
authors: James A
authors: JA
authors: Quintessenza
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D002908:Chronic Disease; D019918:Heart Valve Prosthesis Implantation / Q000379:methods*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008279:Magnetic Resonance Imaging; D011664:Pulmonary Valve / Q000503:physiopathology / Q000601:surgery*; D011665:Pulmonary Valve Insufficiency / Q000503:physiopathology / Q000601:surgery*; D013771:Tetralogy of Fallot / Q000503:physiopathology / Q000601:surgery*; D014694:Ventricular Outflow Obstruction / Q000503:physiopathology / Q000601:surgery*