Systemic-pulmonary shunt facilitates the growth of the pulmonary valve annulus in patients with tetralogy of Fallot

This retrospective study evaluated whether a systemic-PA shunt in infants with TOF facilitated enlargement of the pulmonary valve annulus (PVA).  Placement of a shunt was the only factor associated with PVA growth.  This knowledge may affect how repair is staged with an eye towards avoiding a transannular patch.