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Pulmonary valve replacement with mechanical prostheses in re-do Fallot patients.
Interact Cardiovasc Thorac Surg. 2011 Jun; 12(6):987-91; discussion 991-2.IC

Abstract

In this prospective clinical study, we have compared 17 patients with tetralogy of Fallot (TOF) who received mechanical valve substitutes and had concomitant additional right ventricular (RV) volume reduction plasty (aRVVRP, group 1) with seven patients who underwent solitary re-do pulmonary valve replacements (PVR, group 2). All patients were evaluated by magnetic resonance imaging (MRI) two months pre- and four to six months postoperatively for assessment of ventricular geometry. At a mean follow-up of 31.9 months, the RV ejection fraction improved from 39.1 to 48.3% in group 1 vs. from 40.1 to 49% in group 2 (P<0.001), and RV indexed end-diastolic volume decreased from 174.8 to 119.9 ml/m(2) (group 1) vs. from 142.4 to 99.6 ml/m(2) (group 2, P<0.001). Indexed RV myocardial mass decreased from 52.3 to 38.7 g/m(2) in group 1 vs. 46.9 to 39.1 g/m(2) in group 2 (P<0.001). Follow-up revealed no mortality and distinct improvements in RV geometry, recommending mechanical prostheses as suitable alternatives for PVR. Selection criteria for this solution should consider multiple previous reoperations and assured patient compliance in terms of current anticoagulant usage and self-testing. aRVVRP could serve as an adjunct in re-dos of TOF surgery indicated by RV outflow tract dysfunction due to akinetic fibrous areas.

Authors+Show Affiliations

Division of Cardiac Surgery, Department of Surgery, Medical University of Graz, Auenbruggerplatz 29, A-8036 Graz, Austria.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Video-Audio Media

Language

eng

PubMed ID

21429868

Citation

Ovcina, Ismar, et al. "Pulmonary Valve Replacement With Mechanical Prostheses in Re-do Fallot Patients." Interactive Cardiovascular and Thoracic Surgery, vol. 12, no. 6, 2011, pp. 987-91; discussion 991-2.
Ovcina I, Knez I, Curcic P, et al. Pulmonary valve replacement with mechanical prostheses in re-do Fallot patients. Interact Cardiovasc Thorac Surg. 2011;12(6):987-91; discussion 991-2.
Ovcina, I., Knez, I., Curcic, P., Ozkan, S., Nagel, B., Sorantin, E., Puchinger, M., & Tscheliessnigg, K. (2011). Pulmonary valve replacement with mechanical prostheses in re-do Fallot patients. Interactive Cardiovascular and Thoracic Surgery, 12(6), 987-91; discussion 991-2. https://doi.org/10.1510/icvts.2010.252254
Ovcina I, et al. Pulmonary Valve Replacement With Mechanical Prostheses in Re-do Fallot Patients. Interact Cardiovasc Thorac Surg. 2011;12(6):987-91; discussion 991-2. PubMed PMID: 21429868.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Pulmonary valve replacement with mechanical prostheses in re-do Fallot patients. AU - Ovcina,Ismar, AU - Knez,Igor, AU - Curcic,Pero, AU - Ozkan,Sezen, AU - Nagel,Bert, AU - Sorantin,Erich, AU - Puchinger,Markus, AU - Tscheliessnigg,Karlheinz, Y1 - 2011/03/22/ PY - 2011/3/25/entrez PY - 2011/3/25/pubmed PY - 2011/10/8/medline SP - 987-91; discussion 991-2 JF - Interactive cardiovascular and thoracic surgery JO - Interact Cardiovasc Thorac Surg VL - 12 IS - 6 N2 - In this prospective clinical study, we have compared 17 patients with tetralogy of Fallot (TOF) who received mechanical valve substitutes and had concomitant additional right ventricular (RV) volume reduction plasty (aRVVRP, group 1) with seven patients who underwent solitary re-do pulmonary valve replacements (PVR, group 2). All patients were evaluated by magnetic resonance imaging (MRI) two months pre- and four to six months postoperatively for assessment of ventricular geometry. At a mean follow-up of 31.9 months, the RV ejection fraction improved from 39.1 to 48.3% in group 1 vs. from 40.1 to 49% in group 2 (P<0.001), and RV indexed end-diastolic volume decreased from 174.8 to 119.9 ml/m(2) (group 1) vs. from 142.4 to 99.6 ml/m(2) (group 2, P<0.001). Indexed RV myocardial mass decreased from 52.3 to 38.7 g/m(2) in group 1 vs. 46.9 to 39.1 g/m(2) in group 2 (P<0.001). Follow-up revealed no mortality and distinct improvements in RV geometry, recommending mechanical prostheses as suitable alternatives for PVR. Selection criteria for this solution should consider multiple previous reoperations and assured patient compliance in terms of current anticoagulant usage and self-testing. aRVVRP could serve as an adjunct in re-dos of TOF surgery indicated by RV outflow tract dysfunction due to akinetic fibrous areas. SN - 1569-9285 UR - https://www.unboundmedicine.com/medline/citation/21429868/Pulmonary_valve_replacement_with_mechanical_prostheses_in_re_do_Fallot_patients_ L2 - https://academic.oup.com/icvts/article-lookup/doi/10.1510/icvts.2010.252254 DB - PRIME DP - Unbound Medicine ER -