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): Pieter C. van de Woestijne Peter L. de Jong Johanna J.M. Takkenberg Ad J.J.C. Bogers Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by van de Woestijne, P. C. Articles by Bogers, A. J. J. C. Search for Related Content PubMed PubMed Citation Articles by van de Woestijne, P. C. Articles by Bogers, A. J. J. C. Related Collections Congenital - cyanotic Related Article

---

Original Articles: Pediatric Cardiac

Right Ventricular Outflow Tract Reconstruction With an Allograft Conduit in Patients After Tetralogy of Fallot Correction: Long-Term Follow-Up

^a Department of Cardiothoracic Surgery, Erasmus University Medical Center, Rotterdam, The Netherlands
^b Departments of Congenital Cardiology and Pediatric Cardiology, Erasmus University Medical Center, Rotterdam, The Netherlands

Accepted for publication February 11, 2011.

^_* Address correspondence to Dr van de Woestijne, Department of Cardiothoracic Surgery, Room Bd 575, Erasmus University Medical Center, PO Box 2040, 3000 CA Rotterdam, The Netherlands (Email: p.vandewoestijne{at}erasmusmc.nl).

Background: In tetralogy of Fallot (TOF) pulmonary regurgitation is a frequent complication after initial repair. The objective of the present study was to describe the long-term experience with the use of allograft conduits for right ventricular outflow tract (RVOT) reconstruction after correction of TOF in our institution.

Methods: Between 1987 and 2009, 133 allografts were implanted in 126 patients (mean age, 27.8 years). The mean time from initial TOF repair to allograft implantation was 20.8 ± 8.8 years. Kaplan-Meier analyses were done for patient survival, freedom from allograft replacement and freedom from any cardiovascular event.

Results: Hospital mortality was 1.5% (2 patients). Mean follow-up was 8.1 years. Ten other patients died during late follow-up, in 8 patients the cause was heart failure. Patient survival was 95% at 5 years, 91% at 10 years, and 80% at 15 years. Male sex, older patient age at the time of operation, and the use of preoperative diuretics were associated with increased risk of mortality during follow-up. Freedom from allograft replacement was 83% at 10 years and 70% at 15 years. Freedom from any valve-related event was 80% at 10 years and 67% at 15 years.

Conclusions: Right ventricular outflow tract reconstruction after previous TOF repair can be performed with low risk and a low reintervention rate. Allograft conduits function satisfactorily in the pulmonary position at longer-term follow-up. Functional status after allograft implantation in patients with a previous correction of TOF remains good. There is concern about the long-term survival and the occurrence of heart failure.

Related Article

Invited Commentary

Mark G. Hazekamp
Ann. Thorac. Surg. 2011 92: 166. [Extract] [Full Text] [PDF]

This article has been cited by other articles:

				C. Lee, C.-H. Lee, J. G. Kwak, J. Y. Song, W.-S. Shim, E. Y. Choi, S. Y. Lee, and Y. M. Kim Bicuspid pulmonary valve implantation using polytetrafluoroethylene membrane: early results and assessment of the valve function by magnetic resonance imaging Eur J Cardiothorac Surg, March 1, 2013; 43(3): 468 - 472. [Abstract] [Full Text] [PDF]

				M. G. Hazekamp Invited Commentary Ann. Thorac. Surg., July 1, 2011; 92(1): 166 - 166. [Full Text] [PDF]