Question

Discuss the following for a patient with repaired tetralogy of Fallot:
Indication of pulmonary valve replacement

Hint:

Early intervention with pulmonary valve replacement can prevent irreversible right ventricular damage and improve quality of life.

Answer 1

Step 1: Pulmonary Valve Dysfunction in TOF:
1. Pulmonary Valve Regurgitation (PVR): The most common indication for pulmonary valve replacement (PVR) in TOF patients is significant pulmonary valve regurgitation, which can lead to right ventricular dilation and failure.
2. Right Ventricular Dysfunction: If the right ventricle becomes significantly enlarged or shows signs of failure due to prolonged pressure overload, pulmonary valve replacement is recommended to relieve stress on the right ventricle.
3. Exercise Intolerance: Severe exercise intolerance caused by pulmonary valve insufficiency or right heart failure may indicate the need for valve replacement.