Pulmonary Valve Replacement via Left Thoracotomy as an Alternative to Resternotomy.

Most patients with repaired tetralogy of Fallot (TOF) survive to adulthood and suffer from residual right ventricular pathology, mostly pulmonary regurgitation. Pulmonary valve replacement (PVR) is a procedure of choice to alleviate right ventricular dilatation and pulmonary regurgitation. Resternotomy is the standard approach for PVR in patients who have undergone TOF repair. However, these patients require multiple reoperations during their lifetime. We performed minimally invasive redo PVR through left mini-thoratocomy in 2 patients who had previously undergone TOF repair through sternotomy.