Reasearch Awards nomination

Email updates

Keep up to date with the latest news and content from Journal of Cardiothoracic Surgery and BioMed Central.

Open Access Research article

“V-PLASTY”: a novel technique to reconstruct pulmonary valvular and annular stenosis in patients with right ventricular outflow tract obstruction

Hasim Ustunsoy1*, Gokhan Gokaslan1, Ozerdem Ozcaliskan1, Cem Atik1, Osman Baspinar2, Yavuz Arslanoglu1 and Eren Oral Kalbisade1

Author Affiliations

1 Department of Cardiovascular Surgery, Gaziantep University Medical Faculty, Gaziantep, Turkey

2 Department of Pediatric Cardiology, Gaziantep University Medical Faculty, Gaziantep, Turkey

For all author emails, please log on.

Journal of Cardiothoracic Surgery 2013, 8:55  doi:10.1186/1749-8090-8-55

Published: 28 March 2013

Abstract

Background

The goal of repair of right ventricular outflow tract obstruction with or without Tetralogy of Fallot (TOF) is to eliminate valvular and/or subvalvular obstruction. However, this operation has a high risk of late complication of pulmonary insufficiency. In this study, we aimed to present early period results of our new technique that we call “V-Plasty” developed to prevent pulmonary insufficiency after pulmonary valve reconstruction in selected patients.

Methods

Between January 2006 and January 2010, we performed V-plasty for pulmonary valve reconstruction in 10 patients. Eight patients (5 males, 3 females) had TOF and 2 patients (1 male, 1 female) had atrial septal defect concomitant with pulmonary valve stenosis. Patient selection for V-plasty reconstruction was made due to the pulmonary valve anatomy and degree of stenosis. The mean follow-up time was 55.7 ± 16.2 months (ranging from 32 to 80 months).

Results

Functional capacity of the patients improved immediately after the surgery. There were no mortality and re-operation in follow-up period. Patients were followed up with echocardiography one week after the operation, at 1st, 6th, 12th months and annually. There was no pulmonary insufficiency.

Conclusions

Operative correction of the pulmonary outflow tract obstruction with or without TOF, frequently requires transannular enlargement because of the infundibular and/or annular-valvular obstruction. This conventional technique is usually a reason for late pulmonary insufficiency. In our study, we have not seen pulmonary insufficiency in early term follow-up period. Our early term results are encouraging, but long term follow-up results are needed with large case series.

Keywords:
Congenital heart disease; Tetralogy of fallot; Pulmonary valve stenosis