ISSN : 1301-5680
e-ISSN : 2149-8156
TURKISH JOURNAL OF
THORACIC AND
CARDIOVASCULAR SURGERY
Turkish Journal of Thoracic and Cardiovascular Surgery     
Early Results of Pericardial Monocuspid Valve Reconstruction For Right Ventricular Outflow Tract Obstruction
Bahadır Dağlar1, M. Adnan Celkan1, Hakkı Kazaz1, Osman Başpınar2
1Gaziantep Üniversitesi Tıp Fakültesi, Kalp ve Damar Cerrahisi Anabilim Dalı, Gaziantep
2 Gaziantep Üniversitesi Tıp Fakültesi, Pediatrik Kardiyoloji Bilim Dalı, Gaziantep
Background: We evaluated the early results of pericardial monocuspid valve reconstruction performed to treat right ventricular outflow tract (RVOT) obstruction accompanied by congenital cardiac malformations and to reduce pulmonary regurgitation after complete repair.

Methods: Five patients (3 girls, 2 boys; mean age 8.4 years; range 3 to 17 years) underwent surgical treatment for congenital cardiac pathologies and severe RVOT obstruction. Three patients had atrial septal defect and pulmonary stenosis, and two patients had tetralogy of Fallot. All the operations were performed with median sternotomy and cardiopulmonary bypass. Following correction of the primary congenital cardiac malformation, the RVOT obstruction was reconstructed with fresh pericardial monocuspid valve. The mean follow-up was 12.4±1.2 months (range 6 to 20 months).

Results: The mean cross-clamp time was 75.4±4.3 minutes and the mean total cardiopulmonary bypass time was 98.2±7.6 minutes. At surgery, the mean pulmonary annulus was measured as 14.0±2.3 mm. The mean pulmonary valvular gradients were 58.3±11.5 mmHg and 9.0±4.2 mmHg before and after surgery, respectively. There was no perioperative or postoperative mortality. All the patients were asymptomatic and in NYHA class I during the followup period. On postoperative echocardiography, none of the patients had a valvular gradient exceeding 15 mmHg. Only one patient had grade 3 pulmonary regurgitation. The remaining patients had no pulmonary valvular regurgitation.

Conclusion: Due to its feasibility and cost-effectiveness, the pericardial monocuspid valve reconstruction may be an appropriate alternative in treating RVOT obstruction accompanied by congenital cardiac malformations.

Keywords : Aortic valve insufficiency; child; pericardium/transplantation; pulmonary valve/surgery; pulmonary valve insufficiency/ complications/surgery; tetralogy of Fallot/surgery; ventricular outflow obstruction/surgery
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