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Redo Fallot: Surgery for Pulmonary Valve Implantation

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Surgery of Conotruncal Anomalies

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Abstract

Since tetralogy of Fallot was first successfully repaired in 1954, an encouraging long-term survival has been reported. However, an increasing number of adult survivors will present late after repair for re-intervention, and pulmonary regurgitation has been the most common indication. The timing and indications for pulmonary valve replacement continue to evolve but the trend has now moved towards earlier intervention before irreversible changes in right ventricular function occur. Late survivors are also at an increased risk of developing arrhythmias due to right ventricular scarring related to corrective surgery and sudden death remains the commonest cause of late death. The need to restore pulmonary valve competency to preserve right ventricular function and reduce the arrhythmia burden have therefore become the important indications for late intervention in this disease. In addition to traditional surgical approaches, the role of percutaneous valve intervention is also emerging. It is anticipated that this strategy will improve the long-term mortality and morbidity and will be the focus of this chapter.

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Acknowledgement

Dr. N Wilson MD illustrated the figures in this chapter.

Author information

Authors and Affiliations

  1. Department of Pediatric Cardiac Surgery, Children’s Hospital of Colorado, Aurora, CO, USA

    Ed Peng MD, FRCS(CTh)(UK)

  2. Department of Pediatric Cardiology, Children’s Hospital Colorado, Denver, CO, USA

    Neil Wilson MD

  3. Department of Pediatric Cardiothoracic Surgery, Children’s Hospital of Colorado, Aurora, CO, USA

    Robert A. Hanfland MD

  4. Department of Pediatric Cardiovascular Surgery, The Children’s Hospital Colorado Heart Institute, University of Colorado Denver Health Sciences Center, Aurora, CO, USA

    David Neil Campbell MD

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  1. Ed Peng MD, FRCS(CTh)(UK)
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  2. Neil Wilson MD
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  3. Robert A. Hanfland MD
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  4. David Neil Campbell MD
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Correspondence to David Neil Campbell MD .

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Editors and Affiliations

  1. Royal Brompton Hospital, London, United Kingdom

    Francois Lacour-Gayet

  2. C.S. Mott Children’s Hospital, University of Michigan, Ann Arbor, Michigan, USA

    Edward L. Bove

  3. German Pediatric Heart Center, Asklepios Klinik Sankt Augustin Gmb, Sankt Augustin, Germany

    Viktor Hraška

  4. University of Pittsburgh Medical School, Pittsburgh, Pennsylvania, USA

    Victor O. Morell

  5. Department of Cardiothoracic Surgery, Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania, USA

    Thomas L. Spray

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Peng, E., Wilson, N., Hanfland, R.A., Campbell, D.N. (2016). Redo Fallot: Surgery for Pulmonary Valve Implantation. In: Lacour-Gayet, F., Bove, E., Hraška, V., Morell, V., Spray, T. (eds) Surgery of Conotruncal Anomalies. Springer, Cham. https://doi.org/10.1007/978-3-319-23057-3_12

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  • DOI: https://doi.org/10.1007/978-3-319-23057-3_12

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