Pediatrics & Therapeutics
Open Access
ISSN: 2161-0665
+44 1478 350008
ISSN: 2161-0665
+44 1478 350008
Emile Bacha
Morgan Stanley Children��?s Hospital of New York, USA
Posters-Accepted Abstracts: Pediat Therapeut
Purpose: To determine whether patch augmentation of the anterior cusp of the pulmonary valve allows for valve-sparing repair in patients with more severe pulmonary stenosis and improves mid-term valve function following Tetralogy of Fallot (TOF) repair. Methods: Clinical data for all patients who underwent repair of TOF with pulmonary stenosis between 1/2010 and 5/2012 at a single institution were retrospectively reviewed. An anterior cusp augmentation technique using a biological patch was performed in patients who were not candidates for pulmonary valvotomy alone. Echocardiographic measurements of pulmonary valve and right ventricular function were analyzed at termination of bypass, at discharge and at latest follow-up. Patients were categorized by type of repair: no valve intervention (No), pulmonary valvotomy (PV), patch augmentation (Paug) and transannular patch (TAP). After evaluating all groups for preoperative clinical characteristics, the Paug and TAP groups had similar values and pulmonary valve z scores. Outcomes for these two groups were therefore compared. Results: All patients survived and there were no major complications. Each group was homogeneous with regard to baseline patient characteristics. Baseline characteristics of Paug and TAP groups were similar, suggesting that in selected patients, cusp augmentation was used in place of transannular patch. While 100% of TAP patients showed more than moderate PR at last follow up echocardiogram, only 39% of Paug patients showed more than moderate PR. Conclusions: Using a patch augmentation technique, 61% of patients who would have otherwise received a TAP have a competent valve in a mid-term follow-up. Longer follow-up is necessary to ascertain the durability of this technique.
Email: eb2709@cumc.columbia.edu