Pulmonary Valve Replacement With Mechanical Or Bio Prostheses In Post Tetrology Of Fallot Repair Using Minimally Invasive Approach
Devagourou Velayoudam, MCh.
AIIMS,NEW DELHI INDIA, NEW DELHI, India.
OBJECTIVE:-Tetralogy of Fallot is a common cyanotic congenital heart disease which may require trans annular patch during correction causing free pulmonary regurgitation.Free pulmonary regurgitation causes right ventricle dysfunction causing decrease in quality of life .Pulmonary valve replacement before significant dysfunction sets in causes improvement in quality of life .Trans catheter valve replacement is not availabe at our institute . We report our experience of pulmonary valve replacement through minimally invasive technique.METHODS:-We at all India institute of medical sciences NEW DELHI did 15 pulmonary valve replacements from January 2016 to November 2019 through minimally invasive upper mini sternotomy or through mini left thoracotomy. Patients data were analysed and recorded. RESULTS:Mean age was 24.5 years(20-32 years). male: female ratio was 8:7, 13 patients were operated through upper mini sternotomy and 2 patients through mini left thoroctomy. Mean cardiopulmonary bypass time was 96 min(80-120 min).The pulmonary valve replacement was done by continuous suture.Ten patients had a bioprosthesis and 5 had a mechanical valve .Mean extubation time was 4.5 hours(3-6),mean ICU stay was 1.5 days(1-2),mean hospital stay was 4 days(3-5).No wound infection noted in these patients. Postoperative pain is considerable less compared to standard redo sternotomy. CONCLUSION:-Pulmonary valve replacement through mini invasive technique is reproducible and safe.
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