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Severe pulmonary insufficiency should be conservatively treated

Published online by Cambridge University Press:  08 September 2005

J. William Gaynor
J. William Gaynor
Affiliation:
Daniel M. Tabas Endowed Chair in Pediatric Cardiothoracic Surgery, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, United States of America
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Extract

It's always hard to follow a presentation by Carl Backer. Today, we have heard several presentations about the problem of pulmonary insufficiency. We have been shown multiple images of dilated and poorly functioning right ventricles. The obvious conclusion is that these patients should undergo replacement of the pulmonary valve. I agree with Carl that operative morbidity and mortality for replacing the pulmonary valve is minimal, but we must also consider the outcomes in the long-term. Most physicians would agree that valvar replacement is indicated in a symptomatic patient with right heart failure and exercise intolerance. In order to win this debate, therefore, it will necessary to redirect and alter the question! The question I am going to consider is: “should we replace prophylactically the pulmonary valve in asymptomatic patients with pulmonary insufficiency and right ventricular dilation?

Type
PART 2: TETRALOGY OF FALLOT
Information
Cardiology in the Young , Volume 15 , Supplement S1: Controversies Concerning the Ventriculo-Arterial Junctions and Other Topics , February 2005 , pp. 68 - 71
Copyright
© 2005 Cambridge University Press

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