Abstract
Background
Pulmonary valve replacement (PVR) is often performed in patients with repaired tetralogy of Fallot (TOF). Concomitant tricuspid valvuloplasty (TVP) in those with tricuspid regurgitation (TR) at the time of PVR is still controversial.
Method
We retrospectively reviewed clinical records of patients who underwent PVR between 2001 and 2012. We analyzed the impact of concomitant TVP on the tricuspid valve function and right ventricle function and size in mid-term.
Results
119 patients with mild to moderate TR at the time of PVR were enrolled. 33 patients underwent concomitant TVP (TVP group) and 86 patients underwent PVR alone (no-TVP group). There was a significant reduction of TR (p < 0.001) and right ventricular end-diastolic volume index (RVEDVi) (p < 0.001). However, in patients who showed prosthetic pulmonary valve (PV) failure at the last follow-up, there was no significant decrease in TR regardless of concomitant TVP. In the patients with preserved prosthetic PV function, TR was significantly improved (p < 0.001 in both groups). The multivariable analysis showed that significant risk factors for recurrence of significant TR were preoperative moderate TR and prosthetic PV failure.
Conclusions
After PVR in repaired TOF patients, there was an improvement in the degree of TR and the RVEDVi. Concomitant TVP at the time of PVR may not be able to prevent the recurrence of TR when prosthetic PV failure occurs; however, it may effectively preserve tricuspid valve function until that time.
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Data Availability
The deidentified participant data will not be shared.
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Institutional Review Board of Seoul National University Hospital: Approval No. 1809-148-973. Institutional Review Board of Sejong General Hospital: Approval No. 2014-158.
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This topic was presented as an “oral presentation” at Congenital Heart Disease Simultaneous Scientific Session of 99th annual meeting of American Association for Thoracic Surgery, May 5th, 2019, Toronto, Canada.
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Min, J., Kwak, J.G., Cho, S. et al. Tricuspid Valve Repair at Pulmonary Valve Replacement in Repaired Tetralogy of Fallot. Pediatr Cardiol 43, 74–81 (2022). https://doi.org/10.1007/s00246-021-02694-y
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DOI: https://doi.org/10.1007/s00246-021-02694-y