Use of Right Ventricular Remodeling Surgery with a Porcine Pulmonary Prosthesis for Congenital Heart Disease

Use of Right Ventricular Remodeling Surgery with a Porcine Pulmonary Prosthesis for Congenital Heart Disease

Author Maluf, Miguel A. Autor UNIFESP Google Scholar
Carvalho, Antonio C. C. Autor UNIFESP Google Scholar
Carvalho, Werther B. Autor UNIFESP Google Scholar
Institution Universidade Federal de São Paulo (UNIFESP)
Abstract Background: the reconstruction of the right ventricular outflow tract (RVOT) in congenital heart disease has attracted the interest of cardiac surgeons determined to alleviate the anatomic obstruction and restore RV function.Methods: From June 1991 to September 2008, 203 consecutive patients (mean, 3.0 years; range, 2 months to 35 years) underwent operations. These patients were classified into 5 groups: group 1, tetralogy of Fallot with pulmonary hypoplasia (144 cases, 70.9%); group 2, pulmonary atresia (PA) with ventricular septal defect (VSD) (32 cases, 15.7%); group 3, truncus arteriosus (12 cases, 5.9%); group 4, transposition of the great arteries with left ventricular outfl ow tract obstructions (8 cases, 3.9%); and group 5, PA with intact ventricular septum (7 cases, 3.4%). Remodeling surgery of the RV consisted of patch closure of the VSD (n = 176), tricuspid valvoplasty repair (n = 25), infundibulum muscle resection, and reconstruction of the RVOT (all patients). the Lecompte procedure was performed in 8 patients in group 4, and the one and a half ventricle technique was performed in 7 patients in group 5.Results: There were 21 hospital deaths (10.3%); 180 patients (88.6%) survived. Patients were followed up from 4 to 206 months (mean, 98.0 months). Sixteen patients (8.8%) underwent reoperation for prosthesis dysfunction, with 2 in-hospital deaths (12.5%). the rest of the patients (164, 80.7%) remain free of reoperation.Conclusion: Earlier reconstruction of the pulmonary valve and the RVOT may preserve ventricular performance for a long period. Nevertheless, the porcine pulmonary prosthesis has shown satisfactory results when it has been used for the reconstruction of different types of RV obstructions.
Language English
Date 2011-02-01
Published in Heart Surgery Forum. Charlottesville: Forum Multimedia Publishing, Llc, v. 14, n. 1, p. E40-E50, 2011.
ISSN 1098-3511 (Sherpa/Romeo, impact factor)
Publisher Forum Multimedia Publishing, Llc
Extent E40-E50
Access rights Closed access
Type Article
Web of Science ID WOS:000287699600007

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