Reconstruction of the pulmonary valve and outflow tract with bicuspid prosthesis in tetralogy of Fallot

Reconstruction of the pulmonary valve and outflow tract with bicuspid prosthesis in tetralogy of Fallot

Autor Maluf, Miguel A. Autor UNIFESP Google Scholar
Braile, Domingo M. Autor UNIFESP Google Scholar
Silva, Celia Silva Autor UNIFESP Google Scholar
Catani, Roberto Autor UNIFESP Google Scholar
Carvalho, Antonio C. Autor UNIFESP Google Scholar
Buffolo, Enio Autor UNIFESP Google Scholar
Instituição Universidade Federal de São Paulo (UNIFESP)
Resumo Background. Right ventricular outflow tract and pulmonary valve implant in patients with tetralogy of Fallot may be required to avoid late postoperative right ventricular impairment. the use of porcine bicuspid prosthesis might be a technical alternative, although comprehensive studies on the long-term use of these prostheses are not available.Methods. Sixty-three patients (aged 5 months to 34 years; mean, 6 years) with tetralogy of Fallot and pulmonary hypoplasia underwent surgical repair and enlargement of the right ventricular outflow using preserved porcine pulmonary bicuspid prostheses. Fifty-two patients (82.5%) were followed and underwent clinical evaluation and serial Doppler echocardiography. the first 15 patients (29.4%), with ages ranging from 5 to 16 years (mean, 8.2 years) and postoperative follow-up of 48 to 87 months (mean, 65.1 months) underwent hemodynamic and cineangiographic evaluations.Results. There were 11 deaths (17.4%) in the early postoperative period. of the 52 surviving patients (82.5%), 51 (80.9%) were followed for 1 to 87 months (mean, 42.0 months). Four patients (7.6%) had additional treatment. of the 15 patients (29.1%) undergoing hemodynamic evaluation, 9 (60%), had mild valvular pulmonary insufficiency and 6 (40%) had moderate insufficiency. Only the right ventricle-to-pulmonary artery pressure gradients and the right ventricular ejection fraction showed statistically significant differences between groups. Right ventricular dimension, although increased in all patients, did not show statistically significant differences.Conclusions. Right ventricular outflow tract and pulmonary valve repair in patients with tetralogy of Fallot using a bicuspid porcine pulmonary prosthesis is a simple, reliable procedure with good results in postoperative medium term follow-up. (Ann Thorac Surg 2000;70:1911-7) (C) 2000 by the Society of Thoracic Surgeons.
Idioma Inglês
Data de publicação 2000-12-01
Publicado em Annals of Thoracic Surgery. New York: Elsevier B.V., v. 70, n. 6, p. 1911-1917, 2000.
ISSN 0003-4975 (Sherpa/Romeo, fator de impacto)
Publicador Elsevier B.V.
Extensão 1911-1917
Fonte http://dx.doi.org/10.1016/S0003-4975(00)01933-0
Direito de acesso Acesso aberto Open Access
Tipo Artigo
Web of Science WOS:000166022900034
Endereço permanente http://repositorio.unifesp.br/handle/11600/26416

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