Background: In Japan,homografts and bovine jugular vein conduits were rare chances to use.The operative techniques for tetralogy of Fallot with absent pulmonary valve (TOF/APV) remains controversial as to whether the reconstruction of right ventricular outflow tract (RVOT) and remodeling of pulmonary artries.Morever,treatment of infants has been associated with increased mortality.With respect to the reconstruction of RVOT, some patients need re-operation in the future, and prevention of pulmonary regurgitation(PR) reduce the risk of late right ventricular dysfunction.We suggest a novel procedure for primary repair of TOF/APV.
Methods: Between January 1991 and December 2008, 8 consecutive patients including 6 infants underwent repair of TOF/APV with our new technique.Median age at repair was 9.5 months(range 1-55 months), and median weight was 5.6 kg(range 2.4-14.2 kg). Our surgical technique includes plication of dilatated pulmonary artery and RVOT reconstruction using autologous anterior pulmonary wall as an in-situ mono cusp valve.
Results: There was no early or late death during follow-up(median 54.5 months).One patient required re-operation due to bronchial compression.No patients had severe PR. The ratio of right and light ventricle end diastolic distance(RVEDD/LVEDD) was reduced from median 0.73 to 0.60.Morever,PR didn`t deteriorate in 215 months follow-up,regardless of the somatic growth of the patient..
Conclusions: Based in our findins, we believe that our novel technique results in good outcomes and be feasible in infants or otherwise.Furtheremore,the in-situ mono cusp valve has a possibility to be avoid re-operation in long-term.