Abstract
Some congenital heart defects are unsuitable for complete repair without usage of right ventricle-to-pulmonary
artery conduit. Regardless of material used, all currently available conduits are subjected to degenerative
involution. The leading reasons for reoperation in such patients are pulmonary regurgitation and
return of pulmonary obstruction due to conduit stenosis. Surgical approach in treating of conduit-associated
complications varies. This case report describes successful artificial pulmonary trunk reconstruction with
monocusp patch and tricuspid valve replacement in patient with severe right ventricle dysfunction, developed
in late follow-up after complete repair of type II pulmonary atresia with ventricular septal defect. Despite
critical volumic and functional status of the right ventricle surgery was successful.
References
- Ebert P.A. Second operations for pulmonary stenosis or
insufficiency after repair of tetralogy of Fallot. Am. J.
Cardiol. 1982; 50: 637–40. DOI: 10.1016/0002-9149(82)90333-2
- Dearani J., Danielson G., Puga F., Schaff H., Warnes
C., Driscoll D. et al. Late follow-up of 1095 patients
undergoing operation for complex congenital heart disease
utilizing right ventricle to pulmonary artery conduits.
Ann. Thorac. Surg. 2003; 75: 399–411. DOI:
10.1016/s0003-4975(02)04547-2
- Podzolkov V.P., Zelenikin M.A., Shatalov K.V.Extracardiac conduits in congenital heart surgery.Moscow; 2000 (in Russ.).
- Danilov T.Yu., Mamadshoev B.D. Surgical treatment ofright ventricle-pulmonary artery conduit obstruction.Bakoulev Journal for Cardiovascular Diseases. 2016;17 (1): 4–13 (in Russ.).
- Podzolkov V.P., Kokshenev I.V., Yurlov I.A., Samso-nov V.B., Kovalev D.V., Danilov T.Yu. et al. Experiencereoperations after implantation of artificial pulmonaryartery trunk with radical correction of congenital heartdefects. Children's Heart and Vessels Diseases. 2014; 2:22–9 (in Russ.).
- Shinkawa T., Chipman C., Bozzay T., Tang X., Gossett
J.M., Imamura M. Outcome of right ventricle to
pulmonary artery conduit for biventricular repair.
Ann. Thorac. Surg. 2015; 99 (4): 1357–66. DOI:
10.1016/j.athoracsur.2014.07.095
- Therrien J., Siu S.C., McLaughlin P.R., Liu P.P.,
Williams W.G., Webb G.D. Pulmonary valve replacement
in adults after repair of tetralogy of Fallot: are we
operating too late? J. Am. Coll. Cardiol. 2000; 36:
1670–5. DOI: 10.1016/s0735-1097(00)00930-x
- Discigil B., Dearani J.A., Puga F.J., Schaff H.V., Hagler
D.J., Warnes C.A. et al. Late pulmonary valve
replacement after repair of tetralogy of Fallot. J. Thorac.
Cardiovasc. Surg. 2001; 121: 344–51. DOI: 10.1067/mtc.2001.111209
- Podzolkov V.P., Yurlov I.A., Danilov T.Yu., Gadzhi-ev A.A., Hassan Ali, Kovalev D.V. et al. Prosthetics ofthe pulmonary artery valve in the long terms after radi-cal correction of congenital heart defects with obstruc-tion of pulmonary blood flow. Russian Journal ofThoracic and Cardiovascular Surgery.2008; 4; 4–11(in Russ.)
- Oechslin E.N., Harrison D.A., Harris L., Downar E.,
Webb G.D., Siu S.S. et al. Reoperation in adults with
repair of tetralogy of Fallot: indications and outcomes.
J. Thorac. Cardiovasc. Surg. 1999; 118: 245–51. DOI:
10.1016/s0022-5223(99)70214-x
- Li J., Luo S., Liu F., An Q. Systolic function of right
ventricular outflow tract is a better predictor to exercise
performance after pulmonary valve replacement in
tetralogy of Fallot. Pediatr. Cardiol. 2017; 38 (8):
1556–61. DOI: 10.1007/s00246-017-1695-5
- Alvarez-Fuente M., Garrido-Lestache E., Fernandez-
Pineda L., Romera B., Sénchez I., Centella T. et al.
Timing of PVR: How much can the right ventricle dilate
before it looses its remodeling potential? Circulation.
2017; 31; 136 (18): 1703–13.
- Hazekamp M.G., Kurvers M.M., Schoof P.H., Vliegen
H.W., Mulder B.M., Roest A.A. et al. Pulmonary
valve insertion late after repair of tetralogy of Fallot.
Eur. J. Cardiothorac. Surg. 2001; 19: 667–70. DOI:
10.1016/s1010-7940(01)00656-x
- De Ruijter F.T.H., Weenink I., Hitchcock F.J., Meijboom
E.J., Bennink G.B.W.E. Right ventricular dysfunction
and pulmonary valve replacement after correction
of tetralogy of Fallot. Ann. Thorac. Surg. 2002; 73:
1794–800. DOI: 10.1016/s0003-4975(02)03586-5
- Geva T., Gauvreau K., Powell A.J., Cecchin F., Rhodes
J., Geva J. et al. Randomized trial of pulmonary
valve replacement with and without right ventricular
remodeling surgery. Circulation. 2010; 14 (122): 201–8.
DOI: 10.1161/circulationaha.110.951178
- Quail M.A., Frigiola A., Giardini A., Muthurangu V.,
Hughes M., Lurz P. et al. Impact of pulmonary valve
replacement in tetralogy of Fallot with pulmonary
regurgitation: a comparison of intervention and nonintervention.
Ann. Thorac. Surg. 2012; 94 (5): 1619–26.
DOI: 10.1016/j.athoracsur.2012.06.062
About the authors
- Vladimir P. Podzolkov, Dr. Med. Sc., Professor, Academician of RAS, Head of Department; orcid.org/0000-0002-2863-2072
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Timur Yu. Danilov, Dr. Med. Sc., Leading Researcher; orcid.org/0000-0002-9409-3230
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Asan P. Zhumanov, Postgraduate; orcid.org/0000-0001-9850-1687
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Marat Sh. Mavlyutov, Cand. Med. Sc., Cardiovascular Surgeon; orcid.org/0000-0002-3274-5491
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Aleksandr I. Kosenko, Researcher; orcid.org/0000-0002-3184-1270