{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,2]],"date-time":"2026-11-02T17:04:35Z","timestamp":1793639075020,"version":"4.5.1"},"reference-count":27,"publisher":"Oxford University Press (OUP)","issue":"2","license":[{"start":{"date-parts":[[2022,7,11]],"date-time":"2022-07-11T00:00:00Z","timestamp":1657497600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,7,11]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p\/>\n               <jats:sec>\n                  <jats:title>OBJECTIVES<\/jats:title>\n                  <jats:p>Many centres have recently adopted pulmonary valve (PV) preservation (PVP) during tetralogy of Fallot (ToF) repair. We sought to identify the midterm functional outcomes and risk factors for pulmonary regurgitation after this procedure.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>METHODS<\/jats:title>\n                  <jats:p>All patients undergoing PVP during transatrial\u2013transpulmonary repair for ToF with PV stenosis at our institution between January 2007 and December 2020 were reviewed.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>RESULTS<\/jats:title>\n                  <jats:p>Overall, 73 patients were included. At the index surgery, the body surface area was 0.31\u2009\u00b1\u20090.04 m2, the age was 4.9\u2009\u00b1\u20092.9\u2009months and the preoperative PV z-score was -3.02\u2009\u00b1\u20091.11. At a mean follow-up of 5.3\u2009\u00b1\u20092.7\u2009years, the fractional area change of the right ventricle (RV) was 47.1\u2009\u00b1\u20095.2%, and the tricuspid annular plane systolic excursion z-score was -3.31\u2009\u00b1\u20091.89%. The 5-year freedom from moderate\/severe PV regurgitation was 61.3% [95% confidence interval (CI): 48, 73%]. There was a significant correlation between RV function and moderate\/severe PR at follow-up (R2: 0.08; P\u2009=\u20090.03). A comparison with a group of patients undergoing a transannular patch procedure (N\u2009=\u200933) showed superior outcomes for patients with PVP. The preoperative PV z-score and the degree of PR at discharge were risk factors for the early development of moderate\/severe PR at follow-up [hazard ratio (HR): 0.64; 95% CI: 0.48, 0.86, P\u2009=\u20090.01 and HR: 2.31; 95% CI: 1.00, 5.36, P\u2009=\u20090.04, respectively]. A preoperative PV annulus z-score \u2264 -2.85 was found to be predictive for moderate\/severe PR at 5\u2009years after PVP (HR: 2.56; 95% CI: 1.31, 5.01, P\u2009=\u20090.002).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>CONCLUSIONS<\/jats:title>\n                  <jats:p>A pulmonary valve preservation strategy during tetralogy of Fallot repair should always be attempted. However, a preoperative PV annulus z-score &amp;lt; -2.85 and moderate\/severe regurgitation upon discharge are risk factors for midterm pulmonary regurgitation.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ejcts\/ezac365","type":"journal-article","created":{"date-parts":[[2022,7,18]],"date-time":"2022-07-18T13:45:21Z","timestamp":1658151921000},"source":"Crossref","is-referenced-by-count":13,"title":["Pulmonary valve preservation during tetralogy of Fallot repair: midterm functional outcomes and risk factors for pulmonary regurgitation"],"prefix":"10.1093","volume":"62","author":[{"given":"Alvise","family":"Guariento","sequence":"first","affiliation":[{"name":"Pediatric and Congenital Cardiac Surgery Unit, Department of Cardiac, Thoracic and Vascular Sciences and Public Health, University of Padua , Padua, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chiara A","family":"Schiena","sequence":"additional","affiliation":[{"name":"Pediatric and Congenital Cardiac Surgery Unit, Department of Cardiac, Thoracic and Vascular Sciences and Public Health, University of Padua , Padua, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claudia","family":"Cattapan","sequence":"additional","affiliation":[{"name":"Pediatric and Congenital Cardiac Surgery Unit, Department of Cardiac, Thoracic and Vascular Sciences and Public Health, University of Padua , Padua, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4970-4562","authenticated-orcid":false,"given":"Martina","family":"Avesani","sequence":"additional","affiliation":[{"name":"Pediatric Cardiology Unit, Departments of Women\u2019s and Children\u2019s Health, University of Padua , Padua, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ilias P","family":"Doulamis","sequence":"additional","affiliation":[{"name":"Department of Surgery, Johns Hopkins University School of Medicine , Baltimore, Maryland, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7535-9670","authenticated-orcid":false,"given":"Massimo A","family":"Padalino","sequence":"additional","affiliation":[{"name":"Pediatric and Congenital Cardiac Surgery Unit, Department of Cardiac, Thoracic and Vascular Sciences and Public Health, University of Padua , Padua, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Biagio","family":"Castaldi","sequence":"additional","affiliation":[{"name":"Pediatric Cardiology Unit, Departments of Women\u2019s and Children\u2019s Health, University of Padua , Padua, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giovanni","family":"di Salvo","sequence":"additional","affiliation":[{"name":"Pediatric Cardiology Unit, Departments of Women\u2019s and Children\u2019s Health, University of Padua , Padua, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vladimiro","family":"Vida","sequence":"additional","affiliation":[{"name":"Pediatric and Congenital Cardiac Surgery Unit, Department of Cardiac, Thoracic and Vascular Sciences and Public Health, University of Padua , Padua, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2022,7,15]]},"reference":[{"key":"2023052005153338200_ezac365-B1","doi-asserted-by":"crossref","first-page":"1890","DOI":"10.1016\/S0735-1097(02)01886-7","article-title":"The incidence of congenital heart disease","volume":"39","author":"Hoffman","year":"2002","journal-title":"J Am Coll Cardiol"},{"key":"2023052005153338200_ezac365-B2","doi-asserted-by":"crossref","first-page":"19","DOI":"10.1053\/j.pcsu.2009.01.004","article-title":"The First Stella Van Praagh Memorial Lecture: the History and Anatomy of Tetralogy of Fallot","volume":"12","author":"Van 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