[Re-right ventricular outflow reconstruction]

The timing and indication of re-right ventricular outflow tract reconstruction (reRVOTR) remains controversial. The main cause for reRVOTR is pulmonary stenosis and pulmonary regurgitation. A pressure gradient of more than 50 mmHg between right ventricle and pulmonary artery or a right ventricular systolic pressure/left ventricular systolic pressure ratio higher than 0.7~0.8 is the threshold for recommending reoperation. Pulmonary regurgitation is difficult to quantify and is not an indication for reoperation until there was evidence of increasing right ventricular dilatation. That is, reoperation is recommended when there are mild to moderate pulmonary regurgitation with mild to moderate right ventricular dilatation and severe pulmonary regurgitation with or without right ventricular dilatation. ReRVOTR should be undertaken in maintaining normal right ventricular function, that is,under remaining free of symptoms. Therefore the right ventricular function needs to be assessed over time.