ArticlePediatric cardiology2026
Pulmonary Valve Growth After Valve-Sparing Right Ventricle Outflow Tract Stenting in Tetralogy of Fallot: A Single-Centre Retrospective Cohort Study.
Article in Pediatric cardiology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Right ventricular outflow tract (RVOT) stenting is an established initial palliation for neonates and infants with Tetralogy of Fallot (ToF). However, data on valve-sparing RVOT stenting and its impact on pulmonary valve (PV) growth are limited. Our aim was to evaluate pulmonary valve annular growth following valve-sparing RVOT stenting and to examine how this growth related to the type of definitive surgical repair performed. This retrospective single-centre study included 96 consecutive patients with palliated ToF over a 16-year period. Valve-sparing RVOT stenting was achieved in 46 patients, while 50 underwent valve-crossing stenting. PV growth was assessed using Z-scores in the valve-sparing group, and surgical strategies were compared between groups. In the valve-sparing group, PV annular Z-scores improved significantly from - 4.3 ± 1.3 at stenting to - 2.8 ± 1.0 before surgical repair (P < 0.001). In the valve-crossed group, final stent diameter Z-scores (-3.9 ± 1.9) showed minimal change from baseline (-4.5 ± 1.4). Time to surgical repair did not differ between groups. Definitive repair was achieved in 100% of valve-crossed cases and 95.6% of valve-spared cases, with similar weight between groups. A transannular patch (TAP) was performed in 65.9% of repaired valve-sparing patients and 64% of valve-crossed patients, while RV-PA conduit placement was performed in 22.7% and 36%, respectively. Valve-sparing repair was achieved in 11.4% of repaired patients in the valve-sparing cohort. Valve-sparing RVOT stenting is associated with significant pulmonary valve annular growth prior to definitive repair. Although only a minority of patients ultimately underwent valve-sparing surgery, the observed annular growth suggests that this strategy may increase future suitability for pulmonary valve preservation, subject to anatomical and surgical considerations.
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