HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Bryan E. McDonnell Gary W. Raff William M. DeCampli Thomas L. Spray Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by McDonnell, B. E. Articles by Spray, T. L. Search for Related Content PubMed PubMed Citation Articles by McDonnell, B. E. Articles by Spray, T. L.

Ann Thorac Surg 1999;67:1391-1395
© 1999 The Society of Thoracic Surgeons

---

Original Articles

Outcome after repair of tetralogy of Fallot with absent pulmonary valve

^a Division of Pediatric Cardiothoracic Surgery, the Cardiac Center, The Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
^b Division of Cardiology, the Cardiac Center, The Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
^c Department of Anesthesia and Critical Care, the Cardiac Center, The Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania, USA

Address reprint requests to Dr Gaynor, Department of Cardiac Surgery, Children’s Hospital of Philadelphia, Suite 8527, 34th St and Civic Center Blvd, Philadelphia, PA 19104-4399
e-mail: gaynor{at}email.chop.edu

Presented at the Forty-fifth Annual Meeting of the Southern Thoracic Surgical Association, Orlando, FL, Nov 12–14, 1998.

Background. Tetralogy of Fallot with absent pulmonary valve (TOF/APV) is associated with pulmonary artery dilatation and airway compression.

Methods. Since January 1, 1984, 28 patients with TOF/APV have undergone complete repair (median age 11 days, range 1 day to 16 years).

Results. Thirteen patients were ventilated for respiratory failure preoperatively and extracorporeal membrane oxygenation was used in 3. Twenty-six patients underwent pulmonary artery plication (11 anterior, 15 anterior/posterior). The right ventricular outflow tract (RVOT) was reconstructed with a patch (19), valved conduit (5), or monocusp valve (4). Early mortality was 21.4% (6/28), with 1 late death. All early deaths occurred in infants intubated preoperatively. Survival was 77% (95% confidence limit [CL] 56%, 89%) at 1 year and 72% (95% CL 50%, 86%) at 10 years. After surgery, 3 patients underwent reoperation for persistent respiratory symptoms, which resolved after repeat plication and placement of a valved conduit. Freedom from death or reoperation was 68% (95% CL 46%, 83%) at 1 year and 52% (95% CL 29%, 71%) at 10 years. In a multivariable analysis, only preoperative intubation was associated with a worse outcome (p = 0.04).

Conclusions. Long-term outcome for patients with TOF/APV who survive the initial repair is good. Repeat plication and pulmonary valve implantation may improve outcome in patients with persistent airway compression.

This article has been cited by other articles:

				S. C. Sung, Y. H. Chang, and J. S. Woo Anterior translocaton of pulmonary artery without aortic transection in repair of tetralogy of Fallot with absent pulmonary valve Eur. J. Cardiothorac. Surg., April 1, 2007; 31(4): 742 - 743. [Abstract] [Full Text] [PDF]

				B. Alsoufi, W. G. Williams, Z. Hua, S. Cai, T. Karamlou, C. C. Chan, J. G. Coles, G. S. Van Arsdell, and C. A. Caldarone Surgical outcomes in the treatment of patients with tetralogy of Fallot and absent pulmonary valve Eur. J. Cardiothorac. Surg., March 1, 2007; 31(3): 354 - 359. [Abstract] [Full Text] [PDF]

				J. W. Brown, M. Ruzmetov, P. Vijay, M. D. Rodefeld, and M. W. Turrentine Surgical Treatment of Absent Pulmonary Valve Syndrome Associated With Bronchial Obstruction Ann. Thorac. Surg., December 1, 2006; 82(6): 2221 - 2226. [Abstract] [Full Text] [PDF]

				J. M. Chen, J. S. Glickstein, R. Margossian, M. L. Mercando, W. E. Hellenbrand, R. S. Mosca, and J. M. Quaegebeur Superior outcomes for repair in infants and neonates with tetralogy of Fallot with absent pulmonary valve syndrome. J. Thorac. Cardiovasc. Surg., November 1, 2006; 132(5): 1099 - 1104. [Abstract] [Full Text] [PDF]

				L. Nolke, A. Azakie, P. V. Anagnostopoulos, N. Alphonso, and T. R. Karl The Lecompte Maneuver for Relief of Airway Compression in Absent Pulmonary Valve Syndrome. Ann. Thorac. Surg., May 1, 2006; 81(5): 1802 - 1807. [Abstract] [Full Text] [PDF]

				C. Mavroudis and R. M. Sade The Southern Thoracic Surgical Association 50th anniversary celebration: the impact of STSA pediatric cardiothoracic surgery manuscripts on surgical practice Ann. Thorac. Surg., November 1, 2003; 76(90050): S47 - 67. [Abstract] [Full Text] [PDF]

				V. Hraska, A. Kantorova, P. Kunovsky, and D. Haviar Intermediate results with correction of tetralogy of Fallot with absent pulmonary valve using a new approach Eur. J. Cardiothorac. Surg., April 1, 2002; 21(4): 711 - 715. [Abstract] [Full Text] [PDF]

				D. C. Watson Ann. Thorac. Surg., May 1, 2000; 69(5): 1603 - 1603. [Full Text] [PDF]

				P. M. Kirshbom, J. J. Jaggers, and R. M. Ungerleider TETRALOGY OF FALLOT WITH ABSENT PULMONARY VALVE: SIMPLIFIED TECHNIQUE FOR HOMOGRAFT REPAIR J. Thorac. Cardiovasc. Surg., December 1, 1999; 118(6): 1125 - 1127. [Full Text] [PDF]