Introduction. One of the main problem which may influence the quality of life in remote period after surgical correction of tetralogy of Fallot is development of right ventricular failure due to pulmonary valve incompetence. This problem is a challenge for cardiac surgeons in research of various approaches of the right ventricle outflow tract reconstruction.
Material and methods. In the period from 2014 to 2015 in Bakoulev Scientific Center for Cardiovascular Surgery the new technique of reconstructing the right ventricular outflow tract with retention of the pulmonary valve fibrous ring integrity in tetralogy of Fallot was used at 43 patients. Median age was 7.5 months (varied from 3 to14 months). Median weight was 7.8 kg (varied from 4.6 to 12.5 kg).
Results. Assessment of the results was based on the insufficiency and stenosis of pulmonary valve in the early postoperative period. Considering the fact that the reverse flow of blood will always be present between the valve and patch in this method, the insufficiency of pulmonary valve of 1 and 1.5 degree was evaluated as a good result, 2 and 2.5 degree as satisfactory and a 3 degree as unsatisfactory result. In our study the maximum degree of pulmonary valve insufficiency of 2.5 was registered at 3 of 41 patients. 3 patients had 2 degree of pulmonary valve insufficiency. Other patients did not exceed 1.5 degree of pulmonary valve insufficiency. Thus, a good result was observed at 35 (85%) patients and satisfactory at 6 (15%) patients.
Conclusion. The method of right ventricular outflow tract reconstruction in tetralogy of Fallot with retention of the pulmonary valve fibrous ring integrity has a good immediate result. It’s early to say about efficiency of this method without long-term results.
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About the authors
- Bockeria Leo Antonovich, Academician of RAS and RAMS, Director, orcid.org/0000-0002-6180-2619;
- Svobodov Andrey Andreevich, Dr. Med. Sc., Chief Researcher, orcid.org/0000-0003-2523-5212;
- Berishvili David Olegovich, Head of the Department of Emergency Surgery, Intensive Care of Children with Congenital Heart Disease, orcid.org/0000-0001-7379-345Х;
- Doktorova Viktoriya Petrovna, Postgraduate, orcid.org/0000-0002-1156-9863;
- Sharipov Rashid Abutalibovich, Junior Researcher