Pulmonary regurgitation after tetralogy of Fallot repair: clinical features, sequelae, and timing of pulmonary valve replacement.
Pulmonary regurgitation after tetralogy of Fallot repair: clinical features, sequelae, and timing of pulmonary valve replacement.
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DOI：
10.1111/j.1747-0803.2007.00131.x
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发表时间：
2007-11-01
影响因子：
0.3
通讯作者：
Connolly, Heidi M
中科院分区：
文献类型：
--
作者：
Ammash, Naser M;Dearani, Joseph A;Connolly, Heidi M
法洛四联症修复术后的肺动脉瓣反流是一种常见的术后后遗症，与进行性右心室扩大、功能障碍相关，并且是晚期发病率和死亡率的重要决定因素。尽管肺动脉瓣反流在手术后可以耐受多年，但它可能与进行性运动不耐受、心力衰竭、快速心律失常和晚期猝死有关。它还常常需要重新干预。考虑到人工瓣膜退化的风险和再次手术风险的增加，确定此类干预的适当时机可能非常具有挑战性。对法洛四联症术后患者进行全面、知情和定期的评估，包括评估肺动脉瓣关闭不全、右心结构和功能，对于这些患者的最佳护理至关重要。在经验丰富的三级转诊中心进行肺动脉瓣置换术具有较低的手术发病率和死亡率以及非常好的长期结果。经皮肺动脉瓣置换术的早期结果也很有希望。
Pulmonary regurgitation following repair of tetralogy of Fallot is a common postoperative sequela associated with progressive right ventricular enlargement, dysfunction, and is an important determinant of late morbidity and mortality. Although pulmonary regurgitation may be well tolerated for many years following surgery, it can be associated with progressive exercise intolerance, heart failure, tachyarrhythmia, and late sudden death. It also often necessitates re-intervention. Identifying the appropriate timing of such intervention could be very challenging given the risk of prosthetic valve degeneration and the increased risk of reoperation. Comprehensive informed and regular assessment of the postoperative patient with tetralogy of Fallot, including evaluation of pulmonary regurgitation, right heart structure and function, is crucial to the optimal care of these patients. Pulmonary valve replacement performed in an experienced tertiary referral center is associated with low operative morbidity and mortality and very good long-term results. Early results of percutaneous pulmonary valve replacement are also promising.