title: Pulmonary valve replacement in older children and adults using stented bioprostheses.
abstract: More than 50% of children who undergo repair of tetralogy of Fallot (TOF) using a transannular patch will require pulmonary valve replacement (PVR) in early adulthood. The premise of PVR in this setting is to ameliorate the relentless right ventricular (RV) dilatation that otherwise occurs in the presence of severe pulmonary regurgitation. Severe RV dilatation is associated with RV dysfunction, symptoms of exercise intolerance, tricuspid regurgitation and-occasionally-life-threatening RV failure or dangerous ventricular tachyarrhythmia. Increasingly, patients referred for PVR are asymptomatic young adults with busy lives and dependants. Redo cardiac surgery in this setting is high-stakes surgery. Here, we outline the surgical approach taken in a centre with a history of >1000 such operations.
authors.affiliation: Labatt Family Heart Centre, Division of Cardiovascular Surgery, The Hospital for Sick Children, Toronto, Canada.
authors.forename: Fredrik
authors.initials: F
authors.lastname: Halvorsen
authors.affiliation: Labatt Family Heart Centre, Division of Cardiovascular Surgery, The Hospital for Sick Children, Toronto, Canada.
authors.forename: Christoph
authors.initials: C
authors.lastname: Haller
authors.affiliation: Labatt Family Heart Centre, Division of Cardiovascular Surgery, The Hospital for Sick Children, Toronto, Canada edward.hickey@sickkids.ca.
authors.forename: Edward
authors.initials: E
authors.lastname: Hickey
mesh_terms: D006349:Heart Valve Diseases / Q000601:surgery*; D019918:Heart Valve Prosthesis Implantation / Q000295:instrumentation* / Q000379:methods; D006801:Humans; D008297:Male; D011664:Pulmonary Valve / Q000601:surgery*; D012086:Reoperation; D015607:Stents; D018497:Ventricular Dysfunction, Right
keywords: Pulmonary valve replacement; Tetralogy of Fallot