Pulmonary valve replacement in patients with repaired tetralogy of Fallot: early results for recovery of right ventricular dilatation and QRS duration
Background/aim:
Although pulmonary valve replacement (PVR) improves ventricular function and symptoms, the benefit and optimal
timing of PVR are controversial. This study aimed to evaluate early response to PVR for right ventricle (RV) dilatation and QRS duration.
Materials and methods:
Retrospective analysis was performed for
32 patients with repaired tetralogy of Fallot (TOF) between March
2005 and October 2017. The differences between preoperative and postoperative changes in echocardiographic parameters, clinical
symptoms, and QRS duration were evaluated.
Results:
There were no in-hospital or late deaths. Mean age at the time of PVR was 16.57 ± 7.97 years. The interval between TOF repair
and PVR was 12.99 ± 7.06 years. Postoperative echocardiographic findings showed significant reduction in indexed RV end-diastolic
diameter (RV-EDDI) and the ratio of RV/LV-EDDI (P = 0.001 and P = 0.001, respectively). Higher preoperative RV-EDDI was associated
with decreased change in RV-EDDI after PVR (r = 0.63; P = 0.001). Normalization of RV diameters was found to be independent of age
at PVR, interval between TOF repair and PVR, preoperative QRS duration, and preoperative RV-EDDI.
Conclusion:
Significant improvement in RV diameter and symptoms could be obtained with PVR in patients with severe pulmonary
regurgitation.
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