Tetralogy of Fallot transannular patch repair with or without monocusp valve reconstruction

INTRODUCTION: Tetralogy of Fallot (ToF) is one of the most prevalent cyanotic congenital cardiac abnormalities with four cardinal characteristics (ventricular septal defect (VSD), right ventricular outflow tract obstruction (RVOTO), overriding aorta, and right ventricular hypertrophy (RVH). Transannular patch (TAP) could be efficiently relieved RVOT blockage. A monocusp valve has been employed in several procedures to halt postoperative PR. EVIDENCE ACQUISITION: Literatures reviewed in our study were gathered from PubMed and Google Scholar. Advanced search was conducted on both Google Scholar and PubMed Builder, with the key words used were (“Tetralogy of Fallot [Mesh])” OR “cusp”) AND “transannular” AND “transannular repair” AND “monocusp” AND “pulmonary regurgitation”. We also reviewed the articles cited within the literatures to broaden the search results. EVIDENCE SYNTHESIS: Out of five articles gathered, nearly all of them showed that the insertion of monocusp reduce central venous pressure in the initial postoperative phase, allowing for early extubation and thereby preventing ventilator-related comorbidities. CONCLUSIONS: Transannular patch repair with monocusp valve inserted in pulmonary position reconstruction had considerable advantages in terms of decreasing the length of ICU stay and reducing the degree of perioperative PR in TOF patients.