法洛氏四联症根治术后肺动脉瓣置换术研究进展

法洛氏四联症根治术后肺动脉瓣置换术手术时间，目前尚存在争议。指征包括显著的肺动脉瓣反流合并重度右心室扩大（右心室舒张末容积指数〉150ml／m^2或〉2倍左心室舒张末容积指数）、持续性心房扑动／心房颤动或持续性室性心动过速及QRS间期〉180ms等。术后右心室功能迅速改善，表现为右心室容量、质量的减少，QRS间期缩短等。反流的肺动脉瓣常用同种移植物、生物瓣、机械瓣代替。经导管人工肺动脉瓣置换手术及镶嵌治疗可作为外科手术的补充治疗。

Review of Pulmonary Valve Replacement after Tetralogy of Fallot Repair

In patients with corrected tetralogy of Fallot, timing of pulmonary valve replacement （ PVR） remains controversial. Indica- tions for PVR conclude significant pulmonary regurgitation with severe right ventricular dilation （ right ventricular end-diastolic volume 〉 150 ml/m^2 or 〉 twice left ventricular end-diastolic volume） , sustained atrial flutter/fibrillation or sustained ventrieular tachycardia and QRS dura- tion 〉 180 ms,etc. Right ventricular function improves rapidly after PVR, including reduction of right ventricular volume and mass, and a decrease in QRS duration. A regurgitant pulmonary valve is usually replaced by a pulmonary homograft, a bioprosthetic conduit or a mechanical valve prosthese. Percutaneous pulmonary valve insertion and hybrids can be selected besides traditional operation.