Outcomes of valve-sparing procedures in radical correction of conotruncal defects with pulmonary blood flow obstruction in the world

Authors: Dorokhina E.S., Chernogrivov A.E., Nefedova I.E.

Company: Bakoulev National Medical Research Center for Cardiovascular Surgery, Moscow, Russian Federation

Cite as: Dorokhina E.S., Chernogrivov A.E., Nefedova I.E. Outcomes of valve-sparing procedures in radical correction of conotruncal

Received / Accepted: 18.04.2024 / 23.05.2024

Keywords: tetralogy of Fallot valve-sparing procedures transannular patching

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Abstract

Since 1955, when C.W. Lillehei first performed radical correction of tetralogy of Fallot, surgical treatment of conotruncal defects with pulmonary blood flow obstruction has been constantly improved. Despite the fact that the valve-sparing strategy for the pulmonary valve has gained recognition in recent decades, according to the Society of Thoracic Surgeons, transannular repair is still used in more than 50% of cases. Transannular repair in the long-term results causes severe pulmonary insufficiency, which over time can end to systolic and diastolic dysfunction of the right ventricle. Currently, the maximum possible preservation of the natural architecture of the fibrous ring, pulmonary valve and right ventricular outflow tract is accompanied by the most optimal results in the long-term period. The purpose of this review is to describe the current knowledge on the long-term results of radical correction of tetralogy of Fallot using various techniques.

References

Becker A.E., Connor M., Anderson R.H. Tetralogy of Fallot: a morphometric and geometric study. Am. J. Cardiol. 1975; 35: 402–412. DOI: 10.1016/0002-9149(75)90034-x
Khan S.M., Drury N.E., Stickley J., Barron D.J., Brawn W.J., Jones T.J. et al. Tetralogy of Fallot: morphological variations and implications for surgical repair. Eur. J. Cardiothorac. Surg. 2019; 01; 56 (1): 101–109. DOI: 10.1093/ejcts/ezy474
Bockeria L.A., Podzolkov V.P., Glyantsev S.P., Kokshenev I.V., Loginova S.V. History of surgery of tetralogy of Fallot. Part 1. Description and diagnostics of the defect. Аpproaches to surgical treatment and beginning of development of methods of palliative operations. Children’s Heart and Vascular Diseases. 2005; 2: 3–13 (in Russ.).
Evans W.N. “Tetralogy of Fallot” and Étienne-Louis Arthur Fallot. Pediatr. Cardiol. 2008; 29: 637–640. DOI: 10.1007/s00246-007-9186-8
Abbot M.E. Atlas of congenital cardiac disease. Can. Med. Assoc. J. 1936; 34 (2): 194–195.
Hosseinpour A.R., González-Calle A., Adsuar-Gómez A., Ho S.Y. The predicament of surgical correction of tetralogy of Fallot. Pediatr. Cardiol. 202; 42 (6): 1252–1257. DOI: 10.1007/s00246-021-02662-6
Van der Ven Jelle P.G., van den Bosch E., Bogers C.C., Helbing W.A. Current outcomes and treatment of tetralogy of Fallot. 2019; 29: 8: F1000. Faculty Rev. 1530. DOI: 10.12688/f1000research.17174.1
Bockeria L.A., Podzolkov V.P., Glyantsev S.P., Kokshenev I.V., Loginov D.T. History of surgery of tetralogy of Fallot. Part 2. Evolution of methods of radical surgical treatment. Current state of the problem. Children’s Heart and Vascular Diseases. 2006; 1: 14–26 (in Russ.).
Kirklin J.W., Ellis Jr. F.H., McGoon D.C., DuShane J.W., Swan H.F.C. Surgical treatment for the tetralogy of Fallot by open intracardiac repair. J. Thorac. Surg. 1959; 37: 22–51.
Kirklin J.K., Kirklin J.W., Blackstone E.H., Milano A., Pacifico A.D. Effect of transannular patching on outcome after repair of tetralogy of Fallot. Ann. Thorac. Surg. 1989; 48 (6): 783–791. DOI: 10.1016/0003-4975(89)90671-1
Podzolkov V.P., Kokshenev I.V., Pursanov M.G., Cheban V.N., Sobolev A.V., Chernogrivov A.E. et al. Results of repeated operations in the late periods after radical correction of tetralogy of Fallot and reconstruction of the outflow tract of the right ventricle. Russian Journal of Thoracic and Cardiovascular Surgery. 2007; 4: 11–17 (in Russ.).
Sarrisa G.E., Comas J.V., Tobota Z., Maruszewski B. Results of reparative surgery for tetralogy of Fallot: data from the European Association for Cardio-Thoracic Surgery Congenital Database. Eur. J. Cardiothorac. Surg. 2012: 42: 766–774. disc. 774. DOI: 10.1093/ejcts/ezs478
Romeo J.L.R., Etnel J.R.G., Takkenberg J.J.M, Roos-Hesselink J.W., Helbing W.A., van de Woestijne P. Outcome after surgical repair of tetralogy of Fallot: A systematic review and meta-analysis. J. Thorac. Cardiovasc. Surg. 2020; 159 (1): 220–236. DOI: 10.1016/j. jtcvs.2019.08.127
Gatzoulis M.A., Balaji S., Webber S.A., Siu S.C., Hokanson J.S., Poile C. et al. Risk factors for arrhythmia and sudden cardiac death late after repair of tetralogy of Fallot: a multicentre study. Lancet. 2000; 356: 975–981. DOI: 10.1016/S0140-6736(00)02714-8
Kim H., Sung S.C., Kim S.H., Chang Y.H., Lee H.D., Park J.A. et al. Early and late outcomes of total repair of tetralogy of Fallot: risk factors for late right ventricular dilatation. Interact. Cardiovasc. Thorac. Surg. 2013; 17: 956–962. DOI: 10.1093/icvts/ivt361
Possner M., Tseng S.Y., Alahdab F., Bokma J.P., Lubert A.M., Khairy P. Risk factors for mortality and ventricular tachycardia in patients with repaired tetralogy of Fallot: A systematic review and meta-analysis. Can. J. Cardiol. 2020; 36 (11): 1815–1825. DOI: 10.1016/j.cjca. 2020.01.023
Egbe A.C., Adigun R., Anand V., West C.P., Montori V., Murad H.M. Left ventricular systolic dysfunction and cardiovascular outcomes in tetralogy of Fallot: a systematic review and meta-analysis. Can. J. Cardiol. 2019; 35 (12): 1784–1790. DOI: 10.1016/j.cjca.2019.07.634
Tomonari S., Mathis B.J., Kato H., Matsubara M, Suzuki Y., Suetsugu F., Hiramatsu Yu. Architecture matters: Tissue preservation strategies for tetralogy of Fallot repair. J. Card. Surg. 2021; 36 (8): 2836–2849. DOI: 10.1111/jocs.15584
Mavroudis C.D., Frost J., Mavroudis C. Pulmonary valve preservation and restoration strategies for repair of tetralogy of Fallot. Cardiol. Young. 2014; 24: 1088–1094. DOI: 10.1017/S1047951114001991
Mo-Qi L., Wen-Hong D., Mei J., Zhi-Yuan W., Yan G., Wen-Qian Y. et al. Pulmonary valve annular and right ventricular outflow tract size as predictions values for moderate to severe pulmonary regurgitation after repaired tetralogy of Fallot. Echocardiography. 2020; 37 (10): 1627– 1633. DOI: 10.1111/echo.14839
Kwon M.H., Bacha E.A. Pulmonary valve-sparing techniques for tetralogy of Fallot: A systematic approach for maximizing success and minimizing risk. Semin. Thorac. Cardiovasc. Surg. Pediatr. Card. Surg. Annu. 2020; 23: 24–28. DOI: 10.1053/j.pcsu.2020.02.005
Ito H., Ota N., Murata M., Tosaka Y., Ide Y., Tachi M. et al. Technical modification enabling pulmonary valve-sparing repair of a severely hypoplastic pulmonary annulus in patients with tetralogy of Fallot. Interact. Cardiovasc. Thorac. Surg. 2013; 16: 802–807. DOI: 10.1093/ icvts/ivt095
Golukhova E.Z., Kim A.I., Zavalikhina T.V., Nefedova I.E., Chernogrivov A.E., Avakova S.A. Analysis of medical care for children with congenital heart disease in the Russian Federation and prerequisites for the creation of a register in the modern era of digital medical information systems. Creative Cardiology. 2023; 17 (3): 315–321 (in Russ.). DOI: 10.24022/1997-3187-2023-17-3-315-321
Golukhova E.Z., Kim A.I., Chernogrivov A.E., Semenov V.Yu., Zavalikhina T.V., Nefedova I.E. et al. The state of pediatric cardiology and infant mortality in the subjects of the Russian Federation in 2022. Herald of the Russian Academy of Sciences. 2024; 94: 440–448 (in Russ.). DOI: 10.31857/S0869587324050051
Atmashkin A.A., Kim A.I., Rogova T.V., Grigoryants T.R., Ediev M.O. Tetralogy of Fallot: transatrial reconstruction of the right ventricle outlet tract with the hypoplastic pulmonary valve preservation in infants. Children’s Heart and Vascular Diseases. 2023; 20 (2): 87–99 (in Russ.). DOI: 10.24022/1810-0686-2023-20-2-87-99
Awori M.N., Leong W., Artrip J.H., O’Donnell C. Tetralogy of Fallot repair: optimal z-score use for transannular patch insertion. Eur. J. Cardiothorac. Surg. 2013; 43: 483–486. DOI: 10.1093/ejcts/ezs372
Leobon B., Cousin G., Hadeed K., Breinig S., Alacoque X., Berthomieu L. et al. Tetralogy of Fallot: T-shaped infun-dibulotomy for pulmonary valve-sparing procedure. Interact. Cardiovasc. Thorac. Surg. 2022; 34: 488–491. DOI: 10.1093/icvts/ivab275
Ono Y., Hoashi T., Imai K., Okuda N., Komori M., Kurosaki K. et al. Impact of right ventriculotomy for tetralogy of Fallot repair with a pulmonary valve-sparing procedure. JTCVS Open. 2022: 22; 9: 191–205. DOI: 10.1016/j.xjon.2021.10.061
Yi K., Wang D., Xu J., Zhang X., Wang W., Gao J. et al. Surgical strategies for preservation of pulmonary valve function in a radical operation for tetralogy of Fallot: A systematic review and meta-analysis. Front. Cardiovasc. Med. 2022: 13; 9: 888258. DOI: 10.3389/fcvm.2022.888258
Bacha E. Valve-sparing options in tetralogy of Fallot surgery. Semin. Thorac. Cardiovasc. Surg. Pediatr. Card. Surg. Ann. 2012: 15: 24–26. DOI: 10.1053/j.pcsu.2012.01.006
Bacha E. Valve-sparing or valve reconstruction. Options in tetralogy of Fallot surgery. Semin. Thorac. Cardiovasc. Surg. Pediatr. Card. Surg. Ann. 2014: 20: 79–83. DOI: 10.1053/j.pcsu.2016.09.001
Vida V.L., Angelini A., Guariento A., Frescura C., Fedrigo M., Padalino M. et al. Preserving the pulmonary valve during early repair of tetralogy of Fallot: anatomic substrates and surgical strategies. J. Thorac. Cardiovasc. Surg. 2015; 149 (5): 1358–1363. DOI: 10.1016/j. jtcvs.2015.01.030
Vida V.L., Guariento A., Zucchetta F., Padalino M., Castaldi B., Milanesi O. et al. Preservation of the pulmonary valve during early repair of tetralogy of Fallot: Surgical techniques. Semin. Thorac. Cardiovasc. Surg. Pediatr. Card. Surg. Annu. 2016; 19 (1): 75–81. DOI: 10.1053/j. pcsu. 2015.12.008
Vida V.L., Zucchetta F., Stellin G. Pulmonary valve-sparing techniques during repair of tetralogy of Fallot: the delamination plasty. J. Thorac. Cardiovasc. Surg. 2016; 151 (6): 1757–1758. DOI: 10.1016/j.jtcvs.2016.02.015
Lozano-Balseiro M., Garcia-Vieites M., Martínez-Benda-yán I., García-Hernández I., Cuenca-Castillo J.J., Rueda-Núñez F. et al. Valve- sparing tetralogy of Fallot repair with intraoperative dilation of the pulmonary valve. Mid-term results. Semin. Thorac. Cardiovasc. Surg. 2019; 31 (4): 828–834. DOI: 10.1053/j.semtcvs.2019.04.007
Temur B., Aydın S., Suzan D., Kirat B., Demir I.H., Erek E. Comparison of different pulmonary valve reconstruction techniques during transannular repair of tetralogy of Fallot. J. Card. Surg. 2021; 36 (1): 56–61. DOI: 10.1111/jocs.15133
Sinha R., Gooty V., Jang S., Dodge-Khatami A., Salazar J. Validity of pulmonary valve Z-scores in predicting valve-sparing tetralogy repairs – systematic review. Children. 2019; 6: 67. DOI: 10.3390/children60500675133
Kim D.H., Lee J.H., Choi E., Park C.S., Yun T.J. Optimal pulmonary valve annulus diameter for annulus preservation in tetralogy of Fallot may be far smaller than normal annulus size. Semin. Thorac. Cardiovasc. Surg. 2019; 31 (2): 253–263. DOI: 10.1053/j.semtcvs.2018.10.014
Stewart R.D., Backer C.L., Young L., Mavroudis C. Tetralogy of Fallot: Results of a pulmonary valve-sparing strategy. Ann. Thorac. Surg. 2005; 80: 1431–1439. DOI: 10.1016/j.athoracsur.2005.04.016
Blais S., Marelli А., Vanasse A., Dahdah N., Dancea A., Drolet C. et al. Comparison of long-term outcomes of valve-sparing and transannular patch procedures for correction of tetralogy of Fallot. JAMA Network Open. 2021; 4 (7): 2118141. DOI: 10.1001/jamanetworkopen.2021.18141
Kleinöder J.M., Purbojо A., Blumauer R., Cuomo M., Alkassar M., Dittrich S. et al. Long-term results after Fallot repair. Thorac. Cardiovasc. Surg. 2022; 70: e7–e14. DOI: 10.1055/s-0042-1749098
Sassona L., Houria S., Sternfelda A.R., Cohen I., Lencznera O., Boveb E.L. et al. Right ventricular outflow tract strategies for repair of tetralogy of Fallot: effect of monocusp valve reconstruction. Eur. J. Cardiothorac. Surg. 2013; 43 (4): 743–751. DOI: 10.1093/ejcts/ezs479
Dorokhina E.S., Chernogrivov A.E., Kim A.I., Nefedova I.E. Modern trends in the performance of radical correction of conotruncus malformations with pulmonary blood flow obstruction in infantile patients. Russian Journal of Thoracic and Cardiovascular Surgery. 2024; 66 (4): 461–468 (in Russ.). DOI: 10.24022/0236-2791-2024-66-4-461-468
Kozyrev I.А., Моrozov А.А., Grekhov Е.V., Averkin I.I., Gordeev M.L., Latypov А.K. The immediate results of valve-sparing complete repair of tetralogy of Fallot. Circulation Pathology and Cardiac Surgery. 2019; 23 (1): 9–16 (in Russ.). DOI: 10.21688/1681-3472-2019-1-9-16
Prêtre R., Rosser B., Mueller C., Kretschmar O., Dave H. Recycling of the pulmonary valve: an elegant solution for secondary pulmonary regurgitation in patients with tetralogy of Fallot. Ann. Thorac. Surg. 2012; 94 (3): 850–853. DOI: 10.1016/j.athoracsur.2012.04.037
Golukhova E.Z. Report on the scientific and clinical activity of Bakoulev National Medical Research Center for Cardiovascular Surgery for 2023 and development prospects. The Bulletin of Bakoulev Center. Cardiovascular Diseases. 2024; 25 (Special Issue) (in Russ.). DOI: 10.24022/1810-0694-2024-25S
Mavroudis C., Mavroudis C.D., Frost J. Native pulmonary valve restoration after remote tetralogy of fallot repair: how to do it. World J. Pediatr. Congenit. Heart Surg. 2013; 4 (4): 422–426. DOI: 10.1177/2150135113505296

About the authors

Elizaveta S. Dorokhina, Cardiovascular Surgeon; ORCID
Chernogrivov, Dr. Med. Sci., Chief Researcher, Cardiovascular Surgeon; ORCID
Inessa E. Nefedova, Dr. Med. Sci., Head of Department; ORCID

Chief Editor

Konstantin V. Shatalov
MD, PhD, DSc, Professor
Bakoulev National Medical Research Center for Cardiovascular Surgery

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