Introduction:

The RAA valve was designed in 2018 to prevent chronic PI in surgery for Tetralogy of Fallot. The valve is made intra-operatively using the native right atrial appendage. So far we have operarted on 204 patients with the RAA valve in which 88%  had Tetralogy of Fallot, and 12%  more complex pathologies including pulmonary atresia (11), absent pulmonary valve syndrome (9), Truncus arteriosus (3), TGA-VSD-PS (1 Rastelli and 2 Nikaidoh operations) and TOF-AV canal (2), with the mean age 2.04 years old.

 More recent modifications include the stented RAA valve(S-RAA) used for older patients in pulmonary and tricuspid valve position and the Tubed RAA valve (T-RAA ) for patients without a main pulmonary artery.

Results:

The mean cross clamp time was110.8 min and the mean bypass time 130.4 min. The mean ICU stay was :4.1 days.

There was 6 hospital mortalities (2.8%)(5TOF, 1 Truncus), No one related to RAA valve, and there was one reoperation for Bifurcation PS.

The mean F/U time is 34.6 m (3 to 52) and the median  36.3 m

The early and the last FU echo results are:

PI : Early PI: (99.3.3%) up to mild .  (0.7%) moderate PI.

        last FU PI:  (78%) up to mild PI.  (6.2%) more than mod PI.

PS : early PS: mean gradient : 15.6 mmHg

        Last FU Ps: mean gradient 20.8 mmHg

Conclusion:

The use of the RAA valve in RVOT position is a promising otion to prevent PI in surgery for Tetralogy of Fallot