Recent advances of pulmonary valve replacement after repairing tetralogy of Fallot

With constant refining of surgical methods for tetralogy of Fallot (TOF), the survival rate of TOF children has greatly improved. However, the long-term postoperative complications of TOF have become important prognostic factors. The most common complication of pulmonary regurgitation (PR) may lead to right ventricular dysfunction, exercise intolerance, arrhythmia and even sudden death. As an effective treatment for PR, pulmonary valve replacement (PVR) includes surgical pulmonary valve replacement (SPVR), percutaneous pulmonary valve replacement (PPVR) and hybrid therapy. Bioprosthetic valve has remained a primary choice of substituting pulmonary valve. With the improvements of anticoagulation regimens, mechanical valve has its own applicable population and anticoagulation regimens after PVR are also inconsistent. This article reviews the indications of pulmonary valve replacement after radical TOF operations, selecting pulmonary valve replacements, anticoagulant regimens after radical TOF operations and clinical therapeutic advances. Key words: Pulmonary Valve Insufficiency; Tetralogy of Fallot; Pulmonary valve replacement; Research progress