Use of right atrial appendage for pulmonary valve reconstruction in tetralogy of fallot repair: surgical technique and initial experience at Hanoi Heart Hospital
Main Article Content
Abstract
Objective: To evaluate the feasibility, safety, and short-term efficacy of bicuspid pulmonary valve reconstruction using right atrial appendage tissue during complete repair of Tetralogy of Fallot.
Methods: A prospective descriptive longitudinal study was conducted in 9 patients undergoing complete TOF repair with concomitant pulmonary valve reconstruction using right atrial appendage tissue at Hanoi Heart Hospital.
Results: There was no early mortality. At the time of discharge, the majority of patients had no or only mild pulmonary regurgitation; one patient had moderate regurgitation, and no cases of severe pulmonary regurgitation were observed. The median peak gradient across the right ventricular outflow tract was 15 mmHg (range: 5–35 mmHg). Postoperative recovery and hospital course were uneventful, with a median intensive care unit stay of 5 days (range: 2–14 days) and a median postoperative hospital stay of 13 days (range: 6–27 days). At follow-up intervals of 1–6 months, six patients maintained mild pulmonary regurgitation, while three had moderate regurgitation, and no patient required reintervention.
Conclusions: Bicuspid pulmonary valve reconstruction using autologous right atrial appendage tissue during complete repair of Tetralogy of Fallot is a safe technique with favorable early outcomes. These results suggest potential for expanding its indications to other conditions requiring right ventricular outflow tract and pulmonary valve reconstruction. Further medium- and long-term follow-up in larger cohorts is needed to confirm the value of this technique.
Keywords
Tetralogy of Fallot, pulmonary valve reconstruction, right atrial appendage, transannular patch, right ventricular outflow tract
Article Details
References
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