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European Heart Journal Advance Access originally published online on December 16, 2005
European Heart Journal 2006 27(4):482-488; doi:10.1093/eurheartj/ehi685
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© The European Society of Cardiology 2005. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org

Long-term outcome after surgery for pulmonary stenosis (a longitudinal study of 22–33 years)

J.W. Roos-Hesselink1,*, F.J. Meijboom1, S.E.C. Spitaels1, R.T. vanDomburg1, E.H.M. vanRijen3, E.M.W.J. Utens3, A.J.J.C. Bogers2 and M.L. Simoons1

1Departments of Cardiology, Thoraxcenter Ba 308, Erasmus MC, Rotterdam, Dr Molewaterplein 40, 3015 GD Rotterdam, PO Box 2040, 3000 CA Rotterdam, The Netherlands
2Cardiothoracic Surgery, Thoraxcenter, Erasmus MC, Rotterdam, The Netherlands
3Department of Child and Adolescent Psychiatry, Erasmus MC, Rotterdam, The Netherlands

Received 23 March 2004; revised 18 November 2005; accepted 24 November 2005; online publish-ahead-of-print 16 December 2005.

* Corresponding author: Tel: +31 10 4632432; fax: +31 10 4635498. E-mail address: j.roos{at}erasmusmc.nl

Aims Long-term (>20 years) survival and clinical outcome are only partly documented in patients who underwent surgical repair for isolated pulmonary stenosis. Yet, such data are of critical importance for the future perspectives, medical care, employability, and insurability of these patients.

Methods and results Ninety consecutive patients underwent surgery for pulmonary stenosis between 1968 and 1980 at the Thoraxcenter. A systematic follow-up study was performed in 1990 and again in 2001. Survival after 25 years was 93%. Re-intervention was necessary in 15% of the patients, mainly for pulmonary regurgitation. Right atrial and ventricular dilatation and paradoxical septal motion were associated with the need for reoperation. No major ventricular arrhythmias occurred. Supraventricular arrhythmias occurred, only in patients with severe pulmonary regurgitation and disappeared after reoperation. At last follow-up, 67% of the patients was in NYHA Class I and maximal exercise capacity was 90% of normal. Moderate or severe pulmonary regurgitation was present in 37% of the patients.

Conclusion Although long-term survival and quality of life are good, pulmonary regurgitation is found in a third of the patients 22–33 years after surgical repair for isolated pulmonary stenosis and reoperation for pulmonary regurgitation was necessary in 9%, especially after the transannular patch technique.

Key Words: Pulmonary stenosis • Congenital heart defect • Survival • Follow-up study


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