ISSN : 1301-5680
e-ISSN : 2149-8156
Turkish Journal of Thoracic and Cardiovascular Surgery     
Early and midterm results of valved conduits used in right ventricular outflow tract reconstruction
Ali Rıza Karacı1, Numan Ali Aydemir1, Buğra Harmandar1, Ahmet Şaşmazel1, Türkay Sarıtaş2, Zeliha Tuncel3, Mehmet Salih Bilal1, İbrahim Yekeler1
1Dr. Siyami Ersek Göğüs Kalp ve Damar Cerrahisi Eğitim ve Araştırma Hastanesi, Kalp ve Damar Cerrahisi Kliniği, İstanbul, Türkiye
2Dr. Siyami Ersek Göğüs Kalp ve Damar Cerrahisi Eğitim ve Araştırma Hastanesi, Pediatrik Kardiyoloji Kliniği, İstanbul, Türkiye
3Dr. Siyami Ersek Göğüs Kalp ve Damar Cerrahisi Eğitim ve Araştırma Hastanesi, Anesteziyoloji ve Reanimasyon Kliniği, İstanbul, Türkiye
DOI : 10.5606/tgkdc.dergisi.2012.140
Background: In this article, we present early and midterm results of patients who underwent right ventricular outflow tract (RVOT) reconstructions using different types of valved xenografts.

Methods: Between July 2002 and December 2010, 56 patients (33 males, 23 females; mean age 3.7 years; range 1 month-19 years) who underwent RVOT reconstructions using different types of valved xenografts were included. The mean size of the valved conduits was 16.5 mm (range 11-23 mm). Regarding different types of valved conduits; porcine aortic valve implanted bovine pericardial conduit (LabCor, Sulzer Carbomedics), bovine valved jugular vein (Contegra, Medtronic), glutaraldehyde fixed porcine aortic valved root (Freestyle, Medtronic) and bovine pericardial tube containing stentless porcine pulmonary valve were used in 41, 13, one and one patients, respectively.

Results: Eight patients (14.2%) died in early postoperative period and one patient (1.8%) died in late postoperative period. Conduit stenoses were encountered in 15 patients (31.9%) through the follow-up with a mean of 22.5 months (range 1 month to 6 years). Among the patients with conduit stenosis, mild stenosis was present in 10 (21.2%) (mean gradient 26.5 mmHg), moderate in two (4.2%) (mean gradient 42 mmHg) and severe in three patients (6.3%) (mean gradient 66.6 mmHg). Percutaneous balloon angioplasty was performed in patients with severe conduit stenosis. Following balloon angioplasty, right ventricle (RV)-pulmonary artery (PA) stenosis gradients decreased to 33-37 mmHg in two patients. Intraconduit stent implantation was required in one patient with a RV-PA gradient of 50 mmHg following balloon angioplasty (residual stenosis gradient 30 mmHg).

Conclusion: Valved xenografts seem to be alternatives to pulmonary homografts to be used in RVOT reconstructions. Long-term durability of these conduits should be supported with further studies.

Keywords : Right ventricular outflow tract reconstruction; truncus arteriosus; valved conduit; xenograft
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