PMID- 30587056 OWN - NLM STAT- MEDLINE DCOM- 20200103 LR - 20210109 IS - 2047-9980 (Electronic) IS - 2047-9980 (Linking) VI - 8 IP - 1 DP - 2019 Jan 8 TI - Whether Pulmonary Valve Replacement in Asymptomatic Patients With Moderate or Severe Regurgitation After Tetralogy of Fallot Repair Is Appropriate: A Case-Control Study. PG - e010689 LID - 10.1161/JAHA.118.010689 [doi] LID - e010689 AB - Background Although right ventricular ( RV ) volume was significantly decreased in symptomatic patients with repaired tetralogy of Fallot ( rTOF ) after pulmonary valve replacement ( PVR ), RV size was still enlarged along with RV dysfunction. Methods and Results A prospective case-control study was conducted in a tertiary hospital; 81 asymptomatic repaired tetralogy of Fallot patients with moderate or severe pulmonary regurgitation were enrolled. The enrolled cohort was divided into 2 groups: PVR group (n=41) and medication group (n=40). Cardiac magnetic resonance, transthoracic echocardiography, and electrocardiography were scheduled after recruitment and 6 months after PVR or recruitment. Adverse events were recorded during follow-up. Three deaths, 1 heart transplantation, 3 PVR s, and 2 symptomatic heart failures in medication group and 1 redo PVR in the PVR group were observed during follow-up. Compared with the medication group, the PVR group had significantly lower adverse events rate ( P=0.023; odds ratio, 0.086; 95% CI, 0.010-0.716), and RV function was significantly improved ( P<0.05). Binary logistic regression analysis identified preoperative RV end-systolic volume index (10-mL/m(2) increment, P=0.009; odds ratio, 0.64; 95% CI, 0.457-0.893) was an independent predictor of normalization of RV size after PVR . A preoperative RV end-systolic volume index cut-off value of 120 mL/m(2) (area under curve, 0.819; sensitivity, 90.3%; specificity, 70%) was analyzed by receiver operating characteristic curves for normalized RV size after PVR . Conclusions PVR in asymptomatic repaired tetralogy of Fallot patients is appropriate and effective in reducing right ventricular size and preserving right ventricular function. The recommended criterion of RV end-systolic volume index for PVR is 120 mL/m(2). FAU - He, Fengpu AU - He F AD - 1 Pediatric Cardiac Surgery Center National Center for Cardiovascular Disease and Fuwai Hospital Chinese Academy of Medical Sciences Peking Union Medical College Beijing China. FAU - Feng, Zicong AU - Feng Z AD - 1 Pediatric Cardiac Surgery Center National Center for Cardiovascular Disease and Fuwai Hospital Chinese Academy of Medical Sciences Peking Union Medical College Beijing China. FAU - Chen, Qiuming AU - Chen Q AD - 1 Pediatric Cardiac Surgery Center National Center for Cardiovascular Disease and Fuwai Hospital Chinese Academy of Medical Sciences Peking Union Medical College Beijing China. FAU - Jiao, Yiping AU - Jiao Y AD - 2 Psychological Teaching and Research Department Hangzhou Armed Police Officer School Hangzhou China. FAU - Hua, Zhongdong AU - Hua Z AD - 1 Pediatric Cardiac Surgery Center National Center for Cardiovascular Disease and Fuwai Hospital Chinese Academy of Medical Sciences Peking Union Medical College Beijing China. FAU - Zhang, Hao AU - Zhang H AD - 1 Pediatric Cardiac Surgery Center National Center for Cardiovascular Disease and Fuwai Hospital Chinese Academy of Medical Sciences Peking Union Medical College Beijing China. FAU - Yang, Keming AU - Yang K AD - 1 Pediatric Cardiac Surgery Center National Center for Cardiovascular Disease and Fuwai Hospital Chinese Academy of Medical Sciences Peking Union Medical College Beijing China. FAU - Pang, Kunjing AU - Pang K AD - 1 Pediatric Cardiac Surgery Center National Center for Cardiovascular Disease and Fuwai Hospital Chinese Academy of Medical Sciences Peking Union Medical College Beijing China. FAU - Lu, Minjie AU - Lu M AD - 3 Department of Magnetic Resonance Imaging National Center for Cardiovascular Disease and Fuwai Hospital Chinese Academy of Medical Sciences Peking Union Medical College Beijing China. FAU - Ma, Kai AU - Ma K AD - 1 Pediatric Cardiac Surgery Center National Center for Cardiovascular Disease and Fuwai Hospital Chinese Academy of Medical Sciences Peking Union Medical College Beijing China. FAU - Zhang, Sen AU - Zhang S AD - 1 Pediatric Cardiac Surgery Center National Center for Cardiovascular Disease and Fuwai Hospital Chinese Academy of Medical Sciences Peking Union Medical College Beijing China. FAU - Qi, Lei AU - Qi L AD - 1 Pediatric Cardiac Surgery Center National Center for Cardiovascular Disease and Fuwai Hospital Chinese Academy of Medical Sciences Peking Union Medical College Beijing China. FAU - Wang, Guanxi AU - Wang G AD - 1 Pediatric Cardiac Surgery Center National Center for Cardiovascular Disease and Fuwai Hospital Chinese Academy of Medical Sciences Peking Union Medical College Beijing China. FAU - Li, Shoujun AU - Li S AD - 1 Pediatric Cardiac Surgery Center National Center for Cardiovascular Disease and Fuwai Hospital Chinese Academy of Medical Sciences Peking Union Medical College Beijing China. LA - eng PT - Journal Article PT - Research Support, Non-U.S. Gov't PL - England TA - J Am Heart Assoc JT - Journal of the American Heart Association JID - 101580524 SB - IM MH - Adolescent MH - Asymptomatic Diseases MH - Cardiac Surgical Procedures/*adverse effects MH - Case-Control Studies MH - Child MH - Echocardiography MH - Female MH - Follow-Up Studies MH - Heart Valve Prosthesis Implantation/*methods MH - Heart Ventricles/*diagnostic imaging/physiopathology MH - Humans MH - Male MH - Prospective Studies MH - Pulmonary Valve/diagnostic imaging/*surgery MH - Pulmonary Valve Insufficiency/etiology/physiopathology/*surgery MH - Severity of Illness Index MH - Tetralogy of Fallot/physiopathology/*surgery MH - Treatment Outcome MH - Ventricular Function, Right/*physiology MH - Young Adult PMC - PMC6405720 OTO - NOTNLM OT - asymptomatic OT - magnetic resonance OT - pulmonary valve OT - tetralogy of Fallot EDAT- 2018/12/28 06:00 MHDA- 2020/01/04 06:00 PMCR- 2019/01/08 CRDT- 2018/12/28 06:00 PHST- 2018/12/28 06:00 [entrez] PHST- 2018/12/28 06:00 [pubmed] PHST- 2020/01/04 06:00 [medline] PHST- 2019/01/08 00:00 [pmc-release] AID - JAH33744 [pii] AID - 10.1161/JAHA.118.010689 [doi] PST - ppublish SO - J Am Heart Assoc. 2019 Jan 8;8(1):e010689. doi: 10.1161/JAHA.118.010689.