The reconstruction of right ventricle outflow tract in congenital heart disease has deserved the interest of cardiac surgeons determined to alleviate anatomic obstruction and to return ventricular function.
From June 1991 - March 2008, 191 consecutive patients, aged 4 months to 35 years (M=3.0) were operated. The patients were classified in 5 groups: G1- Tetralogy of Fallot with pulmonary hypoplasia, 136 (71.2%) cases; G2- Pulmonary atresia with ventricular septal defect, 30 (15.7%) cases; G3- Arterial trunk, 10 (5.2%) cases; G4 - Pulmonary atresia with intact ventricular septum, 07 (3.6%) cases and G5 - Transposition of the great arteries with pulmonary stenosis, 08 (4.1%) cases. Repair consisted of patch closure of the ventricular septal defect (n = 184), tricuspid valve repair (n = 15). Transannular pulmonary prosthesis, was performed in all cases. The Lecompte procedure was employed in seven cases and one and a half ventricle repair, in seven cases.
There were 15 hospital deaths (7.8%) and six (3.4%) late death. Fourteen (8.2%) patients were lost during the follow-up. Fifteen (8.8%) cases were reoperated for correction of residual lesions or prosthesis dysfunction. There was one (6.6%) hospital death. One hundred and seventy (89.0%) surviving patients were followed up from 3 to 204 months (M=98.0). One hundred and forty one (82.9%) patients, are free of reoperation.
Right ventricular remodeling constitutes a safe and standardized technique. The early reconstruction of the pulmonary valve and right ventricle outflow tract, could be preserving ventricular performance for a long period, while the prosthesis function is analyzed.