Pulmonic Regurgitation in Tetralogy of Fallot with Absent Pulmonic Valve

the development of the cardiac and pulmonary vascular complications which were observed in these three children. Nine to thirteen years ago when the original mitral valve prostheses were introduced, only the Starr-Edwards ballcage valve was available. Since that time a number of other artificial valves have been offered for clinical use.3 11 In view of the development of left ventricular wall thickening in all three cases and the extension of fibrous tissue onto the valve struts in one, it would seem wise to avoid the use of prosthetic valves which may partially occlude the left ventricular outflow tract in small children. The glutaraldehydepreserved porcine heterograft currently possesses the greatest number of advantages for use in this age group because of its central flow characteristics, favorable effective orifice to anular diameter ratio, low thromboembolic rate without anticoagulants, and proven durability of five or more years.'0' 12, 113