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Innovative technique for repair of Tetralogy of Fallot with absent pulmonary, valve syndrome using autologous pericardial patch with monocusp valve

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Indian Journal of Thoracic and Cardiovascular Surgery Aims and scope Submit manuscript

Abstract

Background

Conventional surgery for absent pulmonary valve is repair with valve conduit between right ventricle (RV) and Pulmonary artery (PA).We describe a technique of repairing absent pulmonary valve with autologous pericardial patch with monocusp valve, without using valve conduit and its results.

Methods

From February 2004 to September 2006, 14 consecutive patients with absent pulmonary valve syndrome (APVS) were repaired using this technique. Age range was 5–168 months (median- 24 months) and weight range was 6–31 kgs (median-10 kgs), 5 were infants. Varying degree of respiratory symptoms were present in all patients including tachypnoea, difficulty in feeding, wheezing, recurrent pneumonia and cyanosis. Repair consisted of ventricular septal defect closure, relief of right ventricular outflow obstruction with autologous pericardial patch with monocusp valve. PA aneurysmorrhaphy and PA reduction arterioplasty were done in selected cases.

Result

There was one mortality. The follow up ranged from 12 months to 36 months, respiratory symptoms disappeared or were significantly improved in all patients. Two dimensional (2D) Echo showed trivial to mild pulmonary regurgitation (PR) in 11 patients & moderate in two patients. One patient had minimal right ventricular outflow tract (RVOT) obstruction. None of them required reintervention.

Conclusion

New innovative technique of using autologous pericardial patch with monocusp valve in absent pulmonary valve syndrome can be safely performed in infants and children. It avoids conduit related problems like reintervention and is economical. Our early and midterm results are encouraging, however long term results are awaited.

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Authors and Affiliations

  1. Department of Pediatric Cardiac Surgery, Apollo Children’s Heart Hospital, Jubilee Hills, Hyderabad, India

    Kandakure Pramod Reddy, Anil Kumar Dharmapuram, Sunil Kumar Swain, Nagarajan Ramdoss, Rohit Agarwal, Vejendla Gouthmi, Sreekanthan Sundararaghavan & Kona Samba Murthy

  2. Innova Children’s Heart Hospital Tarnaka, Moula Ali Road, Secunderabad, 017, India

    Kona Samba Murthy

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  1. Kandakure Pramod Reddy
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  2. Anil Kumar Dharmapuram
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  3. Sunil Kumar Swain
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  4. Nagarajan Ramdoss
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  5. Rohit Agarwal
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  6. Vejendla Gouthmi
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  7. Sreekanthan Sundararaghavan
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  8. Kona Samba Murthy
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Correspondence to Kona Samba Murthy.

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Reddy, K.P., Dharmapuram, A.K., Swain, S.K. et al. Innovative technique for repair of Tetralogy of Fallot with absent pulmonary, valve syndrome using autologous pericardial patch with monocusp valve. Indian J Thorac Cardiovasc Surg 24, 167–170 (2008). https://doi.org/10.1007/s12055-008-0034-0

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  • DOI: https://doi.org/10.1007/s12055-008-0034-0

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