Methods: Seventy-six patients (34 males, 42 females; mean age 11.4±5.8 years; range 7 to 18 years) underwent pulmonary valve replacement for pulmonary insufficiency following right ventricle outflow tract reconstruction between January 2009 and September 2016. Surgical indications were symptoms including exercise intolerance or arrhythmias which are attributed to the right ventricular volume overload or dysfunction with or without branch pulmonary artery stenosis in 54 symptomatic patients with chronic pulmonary insufficiency. Surgical indication was made according to magnetic resonance imaging in 22 asymptomatic patients.

Results: The mean follow-up was 60±19 (range 17 to 108) months. There was no early and late mortality. The mean right ventricular ejection fraction value in symptomatic patients increased in the postoperative period, although it did not reach statistical significance. There was a decline in the right ventricular area index, right ventricular volume index, and tricuspid annulus measurements, compared to preoperative values. Compared to the symptomatic patients, the increase in the right ventricular ejection fraction and the decline in the right ventricular area index, right ventricular volume index, and tricuspid annulus was less prominent in asymptomatic patients, indicating no statistically significant difference.

Conclusion: Pulmonary valve replacement can be performed with low morbidity and mortality rates. To relief the right ventricle function, the operation should be performed before the irreversible changes in the right ventricular volumes and functions occur.