Timing of pulmonary valve replacement after tetralogy of Fallot repair

Luciane Piazza, Massimo Chessa, Alessandro Giamberti, Claudio Maria Bussadori, Gianfranco Butera, Diana Gabriela Negura, Angelo Micheletti, Edward Callus, Mario Carminati

Research output: Contribution to journalArticlepeer-review


Tetralogy of Fallot (TOF) is the most common form of cyanotic congenital heart disease. If left untreated, it carries a 33% mortality in the first year of life and a 50% mortality in the first 3 years of life. Since the introduction of the first open-heart repair by Lillehei and Varco in 1954, surgical management of TOF has evolved to be the primary repair during infancy in the majority of patients. Surgical management of TOF results in anatomic and functional abnormalities in the majority of patients, such as chronic pulmonary valve regurgitation and right ventricular (RV) dysfunction. Long-standing chronic pulmonary valve regurgitation can result in RV dilatation and failure, increasing tricuspid regurgitation, impaired exercise performance and supraventricular or ventricular arrhythmias. A timely reoperation may prevent these consequences, with a complete RV-function recovery. This article provides insight into the questions of when to perform a pulmonary valve implantation and in whom.

Original languageEnglish
Pages (from-to)917-923
Number of pages7
JournalExpert Review of Cardiovascular Therapy
Issue number7
Publication statusPublished - Jul 2012


  • adult with congenital heart disease
  • pulmonary regurgitation
  • tetralogy of Fallot
  • timing

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Internal Medicine


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