Despite excellent outcomes of tetralogy of Fallot (TOF) repair, reinterventions for
recurrent or residual stenosis of branch pulmonary arteries are still required in
many patients. The development of these lesions may be related to 2 inherent characteristic
morphologies of TOF: Pulmonary ductal coarctation and acute angulation of branch pulmonary
artery, especially the left pulmonary artery. I developed a main pulmonary artery
rotation flap angioplasty technique to deal with acute-angle branch pulmonary artery
stenosis without using any patch. Since 1998, 68 TOF patients have undergone this
technique. During a median follow-up of 13.5 years, 20 (29%) patients underwent catheter
or surgical-based intervention for branch pulmonary stenosis. Overall freedom from
any intervention was 87%, 76%, 70%, and 59% at 1-year, 5-year, 10-year, and 20-year
periods, respectively. I believe that this technique is reproducible and provides
excellent intermediate and long-term outcomes in TOF patients with complicated branch
pulmonary artery stenosis.
Keywords
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Published online: July 04, 2022
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