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- W258002104 abstract "Pulmonary insufficiency presents a pathological condition which can occur after correction of congenital malformations of the right outflow tract. The aim of most surgical interventions of the right ventricular outflow tract concerns relief of pulmonary stenosis; if this is accomplished, normal lung perfusion is possible even in the absence of a pulmonary valve. Primary replacement of a pulmonary valve is recommended in cases of pulmonary atresia, truncus arteriosus or TGA, VSD and severe pulmonary stenosis. In tetralogy of Fallot, even with a severely distorted pulmonary valve or a necessary transanular patch at primary correction, valve replacement is generally avoided. It may, however, become necessary many years later (4, 5, 7). Here, in some instances, right heart failure has developed for a variety of reasons, e.g. presence of proximal or distal pulmonary valve or vascular stenosis, significant aortopulmonary collaterals and/or VSD-recurrency all resulting in an elevated pulmonary vascular resistance. These factors will present a high systolic and diastolic load on the right ventricle which ultimately leads to right heart failure with tricuspid insufficiency and its decisive sequelae (Table I). In these patients pulmonary valve replacement will become a necessity to increase life expectancy (1, 3, 4, 10, 21). An example is seen in Fig. 1: a 10-year-old boy who needed a transanular pulmonary outflow tract patch at correction 9 years ago, demonstrated the symptoms of severe right heart insufficiency. Now, 2 years after pulmonary allograft implantation, marked improvement is obvious." @default.
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- W258002104 date "1988-01-01" @default.
- W258002104 modified "2023-09-26" @default.
- W258002104 title "Technique of inlay allografts into the RVOT to prevent pulmonary insufficiency" @default.
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- W258002104 doi "https://doi.org/10.1007/978-3-642-72420-6_32" @default.
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