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Comparison of Different Pulmonary Valve Reconstruction Techniques During Transannular Repair of Tetralogy of Fallot
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  • Bahar Temur,
  • Selim Aydın,
  • Dilek Suzan,
  • Barıs Kırat,
  • Halil Demir,
  • Ersin Erek
Bahar Temur
Acibadem Universitesi Tip Fakultesi

Corresponding Author:[email protected]

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Selim Aydın
Acibadem Universitesi Tip Fakultesi
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Dilek Suzan
Yeni Yuzyil University Gaziosmanpaşa Hospital
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Barıs Kırat
Istanbul Florence Nightingale Hospital
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Halil Demir
Dr Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research Hospital
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Ersin Erek
Acibadem Universitesi Tip Fakultesi
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Background: Transannular patch, which results pulmonary insufficiency (PI), is usually required during repair of Tetralogy of Fallot (TOF). In this study, we compared 3 types of pulmonary valve reconstruction techniques during transannular repair of TOF. Methods: Between February 2014 and January 2018, 50 patients with TOF underwent total repair with transannular patch. These patients were divided into three groups. In group 1, (n= 15), a single gluteraldehyde treated autologous pericardial monocusp (standard method) was reconstructed. In group 2, (n= 16) Nunn’s bileaflet pulmonary valve reconstruction technique was used with autologous pericardial patch. In group 3, (n= 19), Nunn’s bileaflet technique was performed with expanded polytetrafluoroethylene (e-PTFE) membrane. Outcomes of the patients with early and mid-term competency of the pulmonary valves were analyzed. Results: All three pulmonary valve reconstruction techniques were significantly effective in early postoperative period. Freedom from moderate to severe PI were 73.3%; 100% and 89.4% respectively. Mortality, duration of intensive care unit and hospital stay were similar between the groups. The mean follow-up period was 17.5±13.0 (3 to 57) months. Freedom from moderate to severe PI decreased to 40%; 81.2% and 73.7% respectively at the end of the follow-up period. Presence of moderate to severe PI was significantly higher in group 1 (p: 0,018 between group 1 and 2, p: 0,048 between group 1 and grup 3). Conclusions: All three pulmonary valve reconstruction techniques provided competent pulmonary valves. Nunn’s bileaflet technique had better outcome at midterm. This technique has a potential to delay right ventricular dysfunction at long-term.
21 Jun 2020Submitted to Journal of Cardiac Surgery
22 Jun 2020Submission Checks Completed
22 Jun 2020Assigned to Editor
22 Jun 2020Reviewer(s) Assigned
29 Jul 2020Review(s) Completed, Editorial Evaluation Pending
29 Jul 2020Editorial Decision: Revise Minor
25 Sep 20201st Revision Received
26 Sep 2020Submission Checks Completed
26 Sep 2020Assigned to Editor
28 Sep 2020Reviewer(s) Assigned
06 Oct 2020Review(s) Completed, Editorial Evaluation Pending
07 Oct 2020Editorial Decision: Accept
30 Oct 2020Published in Journal of Cardiac Surgery. 10.1111/jocs.15133