Early outcome of fallot repair with preservation of the pulmonary valve annulus versus transannular patch / Mohamed Ezz Eldin Abdelghaffar Azzam ; Supervised Mohamed Rady Aboulezz , Hesham Abdelfattah Shawky , Tarek Ahmed Nosseir

Thesis (Ph.D.) - Cairo University - Faculty of Medicine - Department of Cardiothoracic Surgery

Background: Pulmonary valve incompetence following transannular patch repair of tetralogy of Fallot results in long term morbidity and mortality. Pulmonary valve preservation (PVP) has recently gained recognition even in repair of patients with Z score -3 or less .the aim of the study was to evaluate our results with pulmonary valve preservation versus transannular patch in selected patients with tetralogy of Fallot according to pulmonary valve annulus Z score. Methods: This was a prospective, comparative study that enrolled a total of 50 patients 25 within each group Results: There was no significant difference in age , sex , BSA and oxygen saturation between 2 groups, median Z score in PV preservation -3.22 while in TAP -3.89 (P value =0.001) , mean cross clamp time in PV preservation 48.76±11.65 (P value =0.0001),mean mechanical ventilation in PVP 10.2± 4.50 Hr (P value = 0.005) , mean ICU stay in PVP 4.76 ± 2.0 days (P value=0.03) , median RVOT PG in PVP 30(15-50)mmhg while in TAP 27 (15-76)mmhg (P value > 0.05) , the degree in PV regurgitation in group A none/mild in 20 patients ( 80%) and moderate in 5 patients ( 20%) , in group B non/mild 6 patients (24%) , moderate in 8 patients (32%) and severe in 11 patients (44%) (P value= 0.01) .there was one case of mortality in group A and 3 in group B (P value> 0.05) Conclusion: PV annulus preservation technique should be adopted in almost all patients with TOF due to its superior outcome in maintaining a competent pulmonary valv

Issued also as CD