Jones Matthew I, Qureshi Shakeel A
Evelina London Children's Hospital, Guy's & St Thomas' NHS Foundation Trust, Westminster Bridge Road, London, SE1 7EH, UK.
F1000Res. 2018 May 30;7. doi: 10.12688/f1000research.14301.1. eCollection 2018.
Surgical repair of tetralogy of Fallot (ToF) in childhood is associated with generally good outcomes, and almost all children can be expected to survive until adulthood. However, significant pulmonary regurgitation leading to progressive right ventricular dilatation is common in teenagers or young adults because of the nature of the surgical intervention. In patients whose repair included placement of a right ventricle to pulmonary artery conduit, it has been possible to place a stented valve within the conduit to treat this. Pulmonary regurgitation after repair of ToF via a transannular patch technique has historically involved repeat surgery as the dimensions of the right ventricular outflow tract have been too large for commercially available valves. This review summarises the novel transcatheter valves available for management of pulmonary regurgitation after surgical repair of ToF in patients in whom the dimensions of the right ventricular outflow tract have previously been considered too large for transcatheter valve implantation.
儿童期法洛四联症（ToF）的外科修复通常预后良好，几乎所有儿童都有望存活至成年。然而，由于手术干预的性质，青少年或年轻成人中显著的肺动脉反流导致右心室逐渐扩张的情况很常见。对于那些修复手术包括右心室至肺动脉导管置入的患者，可以在导管内放置带支架瓣膜来治疗这种情况。历史上，通过跨环补片技术修复ToF后的肺动脉反流一直需要再次手术，因为右心室流出道的尺寸对于市售瓣膜来说太大了。本综述总结了新型经导管瓣膜，这些瓣膜可用于治疗ToF外科修复术后肺动脉反流，而这些患者的右心室流出道尺寸此前被认为太大而无法进行经导管瓣膜植入。
