Background : Pulmonary regurgitation (PR) is the most important residual lesion remaining after repairing tetralogy of Fallot. Through a thorough review of the data statistics of patients undergoing pulmonary valve replacement following total correction for tetralogy of fallot, and analyzing these data, the following study was performed and presented below.
Material and Methods: Database search for medical records of patients undergoing pulmonary valve replacement following total correction for tetralogy of fallot,from 2003 to 2007 ,that are 53 cases are gathered, analysed, and presented here.
Results and data synthesis : Age(22.21+/- 6.98 years old), duration between the 2 operations(138.47+/-79.99 months), Right ventricular ejection fraction( mildly decreased in 18.6% of cases, moderately decreased in 67.9% of cases, and severely decreased in 12.2% of cases), aneurysm in outflow tract of right ventricle (20.8%), tricuspid regurgitation(56.6%) , tricuspid stenosis (in 1 case). The valve used for pulmonary valve replacement ( biologic 86.6%),(metallic 11.2%),(Homograft 1.9%).Pulmonary artery pressure( lower than 25 mmhg in 34 cases(64.2%),between 25mmhg to 50 mmhg in 7 cases(13.2%),between 50mmhg and 75mmhg in 1case(1.9%),and more than 75 mmhg in 1 case.
Conclusions: Although right ventricular volume load due to severe pulmonary regurgitation after repaired tetralogy of Fallot can be tolerated for years, there is now evidence that the compensatory mechanisms of the right ventricular myocardium ultimately fail and that if the volume load is not eliminated or reduced the dysfunction might be irreversible.