Valve Creation From Atrial Appendage Tissue for Primary Repair of Tetralogy of Fallot in Infants

We assessed the reintervention rate, pulmonary valve function, and neopulmonary valve (NPV) annulus growth after primary tetralogy of Fallot (ToF) repair with NPV creation from right atrial appendage tissue, retrospectively comparing data from 19 ToF patients who underwent primary repair with NPV creation with a historical cohort of patients who underwent transannular patch (TAP) repair. The median age at NPV surgery was 3.5 months. No mortality was observed. The reintervention rate was similar between the NPV and TAP groups (5% vs 11%, respectively; P = 0.066). At 12 months, 56% of the NPV patients had freedom from moderate or greater pulmonary regurgitation, and the NPV annulus exhibited growth. NPV creation from right atrial appendage tissue is safe and can prevent early pulmonary regurgitation after ToF repair.