EJCTS Click here to go to Siemens website
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
QUICK SEARCH:   [advanced]


     

This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to Personal Folders
Right arrow Download to citation manager
Right arrow Permission Requests
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Levine, A.J.
Right arrow Articles by Brawn, W.J.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Levine, A.J.
Right arrow Articles by Brawn, W.J.
Related Collections
Right arrow Congenital - cyanotic

Eur J Cardiothorac Surg 2001;19:122-126
© 2001 Elsevier Science NL

Early results of right ventricular–pulmonary artery conduits in patients under 1 year of age

A.J. Levinea, P.A. Millerb, O.S. Stumperb, J.G.C. Wrightb, E.D. Siloveb, J.V. De Giovannib, B. Sethiab, W.J. Brawna

a Department of Cardiac Surgery, Birmingham Children's Hospital, Steelhouse Lane, Birmingham, B4 6NH, UK
b Department of Cardiology, Birmingham Children's Hospital, Steelhouse Lane, Birmingham, B4 6NH, UK

Received 10 July 2000; received in revised form 17 October 2000; accepted 17 November 2000.

Corresponding author. Tel.: +44-121-333-9437; fax: +44-121-333-9441
e-mail: secretary.brawnw{at}bhamchildrens.wmids.nhs.uk

Objectives: Management strategies for the repair of many complex heart defects require the implantation of a valved conduit between the right ventricle (RV) and the pulmonary artery (PA), often using aortic or pulmonary homograft valves. Their limited availability, however, has led to the development and use of new conduits. We retrospectively compared our experience with small homografts in patients of less than 1 year of age with the TissueMedTM bioprosthetic valved conduit. Methods: From March 1994 to November 1997 29 patients in their first year of life underwent conduit implantation for complex heart defects. These were retrospectively reviewed in order to determine the incidence of death or conduit stenosis. Seventeen patients received homografts and 12 TissueMedTM conduits. Results: Diagnoses and operative details including conduit size were similar in the two groups and in all cases complete repair of the underlying defect was carried out. Early post-operative mortality was 4/17 (23.5%) in the homograft group and 3/12 (25%) in the TissueMedTM group. Echo Doppler evaluation within 1 month of operation showed no right ventricular outflow tract (RVOT) obstruction in any of the survivors. In the TissueMedTM group 8/9 (77%) survivors have gone on to develop significant RVOT obstruction within 12 months of operation. There have been three late deaths in this group all related to severe RVOT obstruction. Two patients died during an attempt at balloon dilatation and one patient died of progressive right heart failure. Five patients had successful replacement of the TissueMedTM conduit. One child remains well with no evidence of RVOT obstruction. At operation to replace conduit, or at autopsy, the stenoses were related to the deposition of fibrous tissue at the anastomotic suture lines. In the homograft group none of the survivors developed RVOT obstruction during the first 12 months post-operatively. There was one late death (non-cardiac in origin) and one child is awaiting conduit replacement 40 months after initial implantation for obstruction. Conclusions: The homograft is a satisfactory conduit for re-establishment of RV–PA continuity in infancy. Further work needs to be undertaken in order to elucidate the mechanisms of early graft failure in bioprosthetic conduits if these are to be a suitable alternative for RV outflow reconstruction in infants.

Key Words: Right ventricular outflow tract • Conduit • Homograft • Xenograft • TissueMedTM




This article has been cited by other articles:


Home page
 Ann. Thorac. Surg.Home page
W.-H. Kim, S. K. Min, C. H. Choi, J. R. Lee, Y. J. Kim, E.-J. Bae, and C. I. Noh
Follow-Up of Shelhigh Porcine Pulmonic Valve Conduits
Ann. Thorac. Surg., December 1, 2007; 84(6): 2047 - 2050.
[Abstract] [Full Text] [PDF]

Home page
 Asian Cardiovasc. Thorac. Ann.Home page
W. Li, W.-Y. Liu, D.-H. Yi, S.-Q. Yu, and Z.-X. Jin
Histological/Biological Characterization of Decellularized Bovine Jugular Vein
Asian Cardiovasc Thorac Ann, April 1, 2007; 15(2): 91 - 96.
[Abstract] [Full Text] [PDF]

Home page
 Ann. Thorac. Surg.Home page
B. Chiappini, C. Barrea, and J. Rubay
Right Ventricular Outflow Tract Reconstruction With Contegra Monocuspid Transannular Patch in Tetralogy of Fallot
Ann. Thorac. Surg., January 1, 2007; 83(1): 185 - 187.
[Abstract] [Full Text] [PDF]

Home page
 Ann. Thorac. Surg.Home page
A. J. Rastan, T. Walther, I. Daehnert, J. Hambsch, F. W. Mohr, J. Janousek, and M. Kostelka
Bovine jugular vein conduit for right ventricular outflow tract reconstruction: evaluation of risk factors for mid-term outcome.
Ann. Thorac. Surg., October 1, 2006; 82(4): 1308 - 1315.
[Abstract] [Full Text] [PDF]

Home page
 J. Thorac. Cardiovasc. Surg.Home page
D. M. McMullan, G. Oppido, N. Alphonso, A. D. Cochrane, Y. d. d'Acoz, and C. P. Brizard
Evaluation of downsized homograft conduits for right ventricle-to-pulmonary artery reconstruction
J. Thorac. Cardiovasc. Surg., July 1, 2006; 132(1): 66 - 71.
[Abstract] [Full Text] [PDF]

Home page
 Ann. Thorac. Surg.Home page
C. Schreiber, S. Sassen, M. Kostolny, J. Horer, J. Cleuziou, M. Wottke, K. Holper, F. Fend, A. Eicken, and R. Lange
Early graft failure of small-sized porcine-valved conduits in reconstruction of the right ventricular outflow tract.
Ann. Thorac. Surg., July 1, 2006; 82(1): 179 - 185.
[Abstract] [Full Text] [PDF]

Home page
 CirculationHome page
L. F. Peng, D. B. McElhinney, A. W. Nugent, A. J. Powell, A. C. Marshall, E. A. Bacha, and J. E. Lock
Endovascular Stenting of Obstructed Right Ventricle-to-Pulmonary Artery Conduits: A 15-Year Experience
Circulation, June 6, 2006; 113(22): 2598 - 2605.
[Abstract] [Full Text] [PDF]

Home page
 Ann. Thorac. Surg.Home page
J.F. M. Bechtel, P. E. Lange, and H. H. Sievers
Optimal Size of a Monocusp Patch for Reconstruction of a Hypoplastic Pulmonary Root: An Experimental Study in Pigs
Ann. Thorac. Surg., June 1, 2005; 79(6): 2103 - 2108.
[Abstract] [Full Text] [PDF]

Home page
 Eur. J. Cardiothorac. Surg.Home page
D. Boethig, W.-R. Thies, H. Hecker, and T. Breymann
Mid term course after pediatric right ventricular outflow tract reconstruction: a comparison of homografts, porcine xenografts and Contegras
Eur. J. Cardiothorac. Surg., January 1, 2005; 27(1): 58 - 66.
[Abstract] [Full Text] [PDF]

Home page
 Ann. Thorac. Surg.Home page
A. F. Corno, S. D. Qanadli, N. Sekarski, S. Artemisia, M. Hurni, P. Tozzi, and L. K. von Segesser
Bovine Valved Xenograft in Pulmonary Position: Medium-Term Follow-Up With Excellent Hemodynamics and Freedom From Calcification
Ann. Thorac. Surg., October 1, 2004; 78(4): 1382 - 1388.
[Abstract] [Full Text] [PDF]

Home page
 Ann. Thorac. Surg.Home page
A. R. Tiete, J. S. Sachweh, U. Roemer, R. Kozlik-Feldmann, B. Reichart, and S. H. Daebritz
Right ventricular outflow tract reconstruction with the Contegra bovine jugular vein conduit: a word of caution
Ann. Thorac. Surg., June 1, 2004; 77(6): 2151 - 2156.
[Abstract] [Full Text] [PDF]

Home page
 Ann. Thorac. Surg.Home page
K. R. Kanter, D. A. Fyfe, W. T. Mahle, J. M. Forbess, and P. M. Kirshbom
Results with the freestyle porcine aortic root for right ventricular outflow tract reconstruction in children
Ann. Thorac. Surg., December 1, 2003; 76(6): 1889 - 1895.
[Abstract] [Full Text] [PDF]

Home page
 J. Thorac. Cardiovasc. Surg.Home page
R. J. F. Baskett, M. A. Nanton, A. E. Warren, and D. B. Ross
Human leukocyte antigen-DR and ABO mismatch are associated with accelerated homograft valve failure in children: implications for therapeutic interventions
J. Thorac. Cardiovasc. Surg., July 1, 2003; 126(1): 232 - 238.
[Abstract] [Full Text] [PDF]

Home page
 J. Thorac. Cardiovasc. Surg.Home page
P. Herijgers, S. Ozaki, E. Verbeken, A. Van Lommel, B. Meuris, E. Lesaffre, W. Daenen, and W. Flameng
Valved jugular vein segments for right ventricular outflow tract reconstruction in young sheep
J. Thorac. Cardiovasc. Surg., October 1, 2002; 124(4): 798 - 805.
[Abstract] [Full Text] [PDF]

Home page
 Ann. Thorac. Surg.Home page
J. M. Pearl, D. S. Cooper, K. E. Bove, and P. B. Manning
Early failure of the shelhigh pulmonary valve conduit in infants
Ann. Thorac. Surg., August 1, 2002; 74(2): 542 - 549.
[Abstract] [Full Text] [PDF]

Home page
 Ann. Thorac. Surg.Home page
B. Aupecle, A. Serraf, E. Belli, S. Mohammadi, F. Lacour-Gayet, P. Fornes, and C. Planche
Intermediate follow-up of a composite stentless porcine valved conduit of bovine pericardium in the pulmonary circulation
Ann. Thorac. Surg., July 1, 2002; 74(1): 127 - 132.
[Abstract] [Full Text] [PDF]

Home page
 Eur. J. Cardiothorac. Surg.Home page
T. Breymann, W.-R. Thies, D. Boethig, R. Goerg, U. Blanz, and R. Koerfer
Bovine valved venous xenografts for RVOT reconstruction: results after 71 implantations
Eur. J. Cardiothorac. Surg., April 1, 2002; 21(4): 703 - 710.
[Abstract] [Full Text] [PDF]


HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
ANN THORAC SURG ASIAN CARDIOVASC THORAC ANN EUR J CARDIOTHORAC SURG
J THORAC CARDIOVASC SURG ICVTS ALL CTSNet JOURNALS
Copyright © 2001 European Association for Cardio-Thoracic Surgery. Published by Elsevier. All rights reserved.