Methods: The study included 39 patients (mean age 12.1±3.1 years; range 8 to 21 years) who were operated on between 1983 and 1996, and had a follow-up of at least five years. Reconstruction of the right ventricle outflow tract was performed with a transannular and infundibular patch in 26 and 13 patients, respectively. The patients were assessed by telecardiography, echocardiography, and treadmill exercise. The mean follow-up was 7.1±2.1 years (range 5 to 13 years).

Results: Pulmonary valve insufficiency was significantly more common in the transannular patch group (p=0.037). Residual pulmonary gradient was lower than 20 mmHg in all the patients, with no significant difference (p=0.63). In the early postoperative period, it was found that decreases in ventricular pressure ratios were correlated with decreases in the pulmonary gradient. Right ventricle end-diastolic diameters and volumes, stroke volumes, and volume indexes were significantly higher in the transannular patch group, showing dysfunction (p<0.05). In treadmill exercise, all the patients but one in the transannular patch group have performed a mean of 10 metabolic equivalents (METS). Reoperation was planned for one patient in the transannular patch group because of pulmonary valve insufficiency.

Conclusion: Our results suggest that transannular repair with an excessive large patch without considering the ideal diameter is associated with pulmonary valve insufficiency and right ventricular dysfunction.