ISSN : 1301-5680
e-ISSN : 2149-8156
Turkish Journal of Thoracic and Cardiovascular Surgery     
Early surgical outcome of pulmonary valve replacement in patients with right ventricle outflow reconstruction
Bülent Sarıtaş1, Emre Özker1, Murat Özkan1, Özlam Sarısoy2, Canan Ayabakan2
1Departments of Cardiovascular Surgery, Başkent University Istanbul Health Application and Research Center, İstanbul, Turkey
2Departments of Pediatric Cardiology, Başkent University Istanbul Health Application and Research Center, İstanbul, Turkey
DOI : 10.5606/tgkdc.dergisi.2017.14363
Background: In this study, we present our early surgical outcomes of pulmonary valve replacement in patients who underwent right ventricle outflow tract reconstruction.

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.

Keywords : Congenital heart disease; pulmonary valve insufficiency; pulmonary valve replacement
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