Surgical pulmonary valve implantation

With the increasing number of late survivors of surgeries for repair of ToF, the surgical management of the possible surgical sequelae, such as chronic pulmonary-valve insufficiency (PVI) and right ventricular (RV) dysfunction, has become a frequent problem. This is a timely topic of increasing clinical interest, as shown by the fact that pulmonary-valve replacement (PVR) for PVI is the reoperation most frequently performed today in adults with congenital heart disease (ACHD) [1, 2]. Long-standing chronic PVI, in these patients, can result in RV dilatation and failure, increasing tricuspid regurgitation, impaired exercise performance, and supraventricular or ventricular arrhythmias.