OBJECTIVES: To assess the operative and mid-term outcome of a very aggressive pulmonary annulus preservation strategy and pulmonary valve leaflet plasty technique which achieved 95% freedom of transannular patch (TAP) in complete tetralogy repair. METHODS: From August 2006 through May 2010, 139 consecutive @entity1 underwent repair of @entity215 at a median age of 6.5 months, with median weight 7.2kg. None of the @entity1 had a prior shunt. A total of 132 @entity1 (95%) had pulmonary valve annulus-sparing procedures, predominantly through a transatrial and transpulmonary approach (n=120%, 86.3%). Special techniques included generous pulmonary supra-valve patch, @entity4503 pulmonary leaflets plasty, or augmentation to maximally preserve pulmonary annulus. All the @entity1 who survived were followed up closely. RESULTS: Only seven (5.0%) @entity1 had a TAP. Among them, five (71.4%) had doubly committed subarterial defect. None of the tricuspid pulmonary valves need TAP. Preoperative size of pulmonary annulus<-6 is associated with TAP (p<0.001). A total of 12 (13.7%) @entity1 needed repump to do either a ventriculotomy and patch the incision or a TAP to relieve @entity850 . One @entity1 needed a third pump run to do a TAP. The operative mortality was 0.7%, and there was one late death due to hemoptysis. The @entity338 of non-TAP @entity1 was less than mild in 105 (79.5%) and mild to moderate in 27 (20.5%) @entity1 . Three @entity1 had peak gradient greater than 50mmHg across the right ventricle and pulmonary artery at 1-month follow-up, but the gradient dropped to less than 50mmHg in two @entity1 at 6-month follow-up. One @entity1 had a persistent 50-55mmHg gradient across pulmonary valve and he is under close follow-up. CONCLUSIONS: Excellent outcome can be achieved even with 95% freedom of TAP in complete repair of tetralogy. The function of most @entity1 ' pulmonary valve was well preserved.

A new pulmonary valve cusp plasty technique markedly decreases transannular patch rate and improves midterm outcomes of XXXX repair.

@entity1 :: ('9606', 'Species') :: ['patients', 'patient'] @entity4503 :: ('MESH:C562388', 'Disease') :: ['bicuspid'] @entity215 :: ('MESH:D013771', 'Disease') :: ['tetralogy of Fallot'] @entity338 :: ('MESH:D011665', 'Disease') :: ['pulmonary regurgitation'] @entity850 :: ('MESH:D003251', 'Disease') :: ['residual stenosis']
@entity215 :: (MESH:D013771,Disease) :: ['tetralogy of Fallot']
