Evaluation of pulmonary regurgitation following tetralogy of fallot repair

Pulmonary regurgitation [PR] is the most important residual lesion remaining after the repair of Tetralogy of Fallot [TOF]. Through a thorough review of the data, statistics of patients undergoing pulmonary valve replacement following total correction for TOF and analyzing these data, the following study was performed and presented below. Database search for medical records of patients undergoing pulmonary valve replacement following total correction for TOF was performed and the data gathered, analyzed, and presented. The age of the patients [22.21 +/- 6.98 years old], time elapsed between the two operations, right ventricular ejection fraction [mildly decreased, 18.6%; moderately decreased, 67.9%; and severely decreased, 12.2% of cases], aneurysm in the outflow tract of the right ventricle [20.8%], tricuspid regurgitation [56.6%], tricuspid steno sis [1 case], valve type used for pulmonary valve replacement [biologic, 86.6%; metallic, 11.2%; and homograft, 1.9%], pulmonary artery pressure [<25mmHg, 34 cases [64.2%]; 25mmHg - 50mmHg, 7 cases [13.2%]; 50mmHg-75mmHg, 1 case [1.9%], and > 75mmHg, 1 case] were evaluated. Although right ventricular volume overload due to severe pulmonary regurgitation after repair of TOF can be tolerated for years, there is now evidence that the compensatory mechanisms of the right ventricular myocardium ultimately fail and that if the volume overload is not eliminated or reduced, this dysfunction may be irreversible. In light of those data and with better understanding of risk factors for adverse outcomes late after TOF repair, many centers are now recommending early pulmonary valve replacement before symptoms of heart failure develop

Results of Fontan operation with triple anastomosis; A study on 32 patients

Nowadays there are many different modifications for Fontan operation. The optimal technique must include anastomosis as wide as possible without any gradient and turbulent flow. With this concept when we started Fontan operation 10 years ago, we performed a technique and named it 'triple anastomosis' consisting of division of superior vena cava [SVC] and anastomosis of its distal and proximal ends to the right pulmonary artery apart from each other and division of pulmonary trunk, and anastomosis of its distal end to the right auricle. We performed this technique in 32 patients with excellent results. They had good functional class in follow-up