The application of pulmonary valve biorifice for reconstruction of right ventricular outflow tract in tetralogy of Fallot

BACKGROUND To introduce a new technique to create a pulmonary valve biorifice for the reconstruction of the right ventricular outflow tract in tetralogy of Fallot (TOF), and to summarize the initial clinical experiment. METHODS The new technique of reconstructing the right ventricular outflow tract with pulmonary valve biorifice was used in 53 cases of TOF (the observation group). While the conventional technique for reconstructing the right ventricular outflow tract was used in other 50 cases of TOF (the control group). The clinical Data of all cases was reviewed retrospectively. RESULTS The ages, weights, cardiopulmonary bypass time, cardiac arrest time, as well as the post operation ventilation support time were not different significantly between groups. Unlike patients in the control group, patients from the observation group had shorter duration of ICU stay. Post- operation, in the observation group, only 2 cases had a large amount of pleural effusion, 1 case had mid-level effusion and 8 cases had a small amount of pleural effusion. While in the control group, there was 1 case of a large amount of effusion, 5 cases of mid-level effusion and 17 cases of a small amount of pleural effusion. 1 week after the operation, all patients were rechecked by echocardiography and no evidence of pulmonary valve stenosis was found. In the observation group, moderate pulmonary valve regurgitation was found in 8 cases, and mild regurgitation was observed in 15 cases. In the control group, severe regurgitation was observed in 3 cases, moderate regurgitation in 17 cases, and mild regurgitation in 16 cases. 33 cases from the observation group were rechecked six months, post-operation, and moderate-mild pulmonary regurgitation was found in 3 cases. As a follow up, 18 cases from the observation group were rechecked 1 year later, and no pulmonary regurgitation was found. CONCLUSION The new technique to create pulmonary valve biorifice can reduce the pulmonary valve regurgitation, reduce postoperative pleural effusion, and improve the early surgical outcome.