Do we always need a pulmonary valve?

Abstract

Abstract Limited right ventricular (RV) outflow patching with preservation of pulmonary valve function are key therapeutic goals during primary repair of tetralogy of Fallot (TOF). Obligatory severe pulmonary regurgitation (PR) following the repair of tetralogy has variable consequences. This is the story of a 38-year-old young woman (out of several such cases) whom the corresponding author has followed for 37 years after she was operated upon for complete repair of the TOF at 1 year of age. During surgery, her pulmonary valve was completely removed, leaving just a tag of valvar tissue. Despite severe PR, she has enjoyed an unrestricted childhood, got married, had two children, and remains completely symptom-free till date. She has normal RV function and no heart failure. This raises an important philosophical question about the necessity of an intact pulmonary valve for long-term survival.