Hostname: page-component-848d4c4894-nr4z6 Total loading time: 0 Render date: 2024-05-23T01:00:59.356Z Has data issue: false hasContentIssue false

Severe pulmonary valvar insufficiency should be aggressively treated

Published online by Cambridge University Press:  08 September 2005

Carl L. Backer
Division of Cardiovascular-Thoracic Surgery, Children's Memorial Hospital, and the Department of Surgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois, United States of America


My role in the debate between myself and Bill Gaynor is to substantiate the notion that severe pulmonary valvar insufficiency should be treated in aggressive fashion. This gives me few problems. At Children's Memorial Hospital in Chicago, we have a long tradition of favouring early insertion of new pulmonary valves in patients with significant pulmonary valvar insufficiency following repair of tetralogy of Fallot. Our results with this strategy in the current era were first presented in 1986 at the Western Thoracic Surgical Association.1 At that time, we had inserted pulmonary valves late following repair of tetralogy of Fallot in 42 patients. We postulated that early control of pulmonary insufficiency may prevent long-term deterioration in right ventricular function. The fact that this is a controversial issue became immediately apparent during the discussion of our presentation. Dr. Frank Spencer, from New York, stated “I would completely disagree with the concept of electively inserting a porcine valve in a child on the basis of haemodynamic data. I fear that the approach recommended in this presentation is probably treating one disease by creating a worse one.”

© 2005 Cambridge University Press

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)