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Late results of valve xenograft conduits between the right ventricle and the pulmonary arteries in patients with pulmonary atresia and extreme tetralogy of Fallot.
Thorac Cardiovasc Surg. 1984 Aug; 32(4):250-2.TC

Abstract

Between 1975 and 1982, valve xenograft conduits were used to establish continuity between the right ventricle and the pulmonary arteries in 28 patients between the ages of 3 to 39 years (mean 14.7 years) with 4 hospital deaths (14%). The indications for operation were pulmonary atresia types I and II in 7, extreme tetralogy of Fallot with hypoplastic pulmonary artery and valvular ring in 10, secondary obliteration of the infundibulum following Waterston shunt in 4, pulmonary valve insufficiency after transannular right ventricular outflow tract patch in 5 and tetralogy of Fallot with anomalous coronary artery in 2. Twenty-one patients (87%) between 9 and 41 years of age (mean 17.4 years) were available for follow-up 1/2 to 8 years after operation. The late death incidence during the follow-up period was 8% (2/24). Postoperative cardiac catheterization, which included right and left ventriculogram and measurements of gradients, was performed in 14 patients 4 months to 6 years after operation. Four patients were in New York Heart Association (NYHA) class 1, 6 in class II and 4 in class III. The other 7 non-catheterized patients were in class II. There were resting peak systolic gradients of 15 to 35 mmHg in 4, 36 to 55 mmHg and more than 55 mmHg across the xenograft valve and the proximal anastomosis in 4 other patients. The right and left ventricular end-diastolic pressures (RVEDP, LVEDP) averaged 18 and 17.5 mmHg, respectively, in 3 patients. The mean ratio of PRV/PLV quotient in NYHA class I group was 0.3, in class II 0.45 to 0.7 and in class III greater than 0.7 (including 2 with residual VSD and pulmonary hypertension). Late densitometric studies for assessing pulmonary valve competence revealed regurgitant fraction of up to 40% of the total stroke volume in the absence of a residual shunt 2 to 4 years after conduit implantation. Three children underwent uneventful surgical replacement of calcified xenograft conduit 1 1/2 to 4 1/2 years after surgery with antibiotic-sterilized valve allograft. Four other patients have residual ventricular septal defects (VSD), 2 of them underwent surgical reclosure while the other 2 patients with pulmonary hypertension still have their residual VSD open.(

ABSTRACT

TRUNCATED AT 400 WORDS)

Authors

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Pub Type(s)

Journal Article

Language

eng

PubMed ID

6207617

Citation

Yankah, A C., et al. "Late Results of Valve Xenograft Conduits Between the Right Ventricle and the Pulmonary Arteries in Patients With Pulmonary Atresia and Extreme Tetralogy of Fallot." The Thoracic and Cardiovascular Surgeon, vol. 32, no. 4, 1984, pp. 250-2.
Yankah AC, Lange PE, Sievers HH, et al. Late results of valve xenograft conduits between the right ventricle and the pulmonary arteries in patients with pulmonary atresia and extreme tetralogy of Fallot. Thorac Cardiovasc Surg. 1984;32(4):250-2.
Yankah, A. C., Lange, P. E., Sievers, H. H., Radtke, W., Regensburger, D., Heintzen, P. H., & Bernhard, A. (1984). Late results of valve xenograft conduits between the right ventricle and the pulmonary arteries in patients with pulmonary atresia and extreme tetralogy of Fallot. The Thoracic and Cardiovascular Surgeon, 32(4), 250-2.
Yankah AC, et al. Late Results of Valve Xenograft Conduits Between the Right Ventricle and the Pulmonary Arteries in Patients With Pulmonary Atresia and Extreme Tetralogy of Fallot. Thorac Cardiovasc Surg. 1984;32(4):250-2. PubMed PMID: 6207617.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Late results of valve xenograft conduits between the right ventricle and the pulmonary arteries in patients with pulmonary atresia and extreme tetralogy of Fallot. AU - Yankah,A C, AU - Lange,P E, AU - Sievers,H H, AU - Radtke,W, AU - Regensburger,D, AU - Heintzen,P H, AU - Bernhard,A, PY - 1984/8/1/pubmed PY - 1984/8/1/medline PY - 1984/8/1/entrez SP - 250 EP - 2 JF - The Thoracic and cardiovascular surgeon JO - Thorac Cardiovasc Surg VL - 32 IS - 4 N2 - Between 1975 and 1982, valve xenograft conduits were used to establish continuity between the right ventricle and the pulmonary arteries in 28 patients between the ages of 3 to 39 years (mean 14.7 years) with 4 hospital deaths (14%). The indications for operation were pulmonary atresia types I and II in 7, extreme tetralogy of Fallot with hypoplastic pulmonary artery and valvular ring in 10, secondary obliteration of the infundibulum following Waterston shunt in 4, pulmonary valve insufficiency after transannular right ventricular outflow tract patch in 5 and tetralogy of Fallot with anomalous coronary artery in 2. Twenty-one patients (87%) between 9 and 41 years of age (mean 17.4 years) were available for follow-up 1/2 to 8 years after operation. The late death incidence during the follow-up period was 8% (2/24). Postoperative cardiac catheterization, which included right and left ventriculogram and measurements of gradients, was performed in 14 patients 4 months to 6 years after operation. Four patients were in New York Heart Association (NYHA) class 1, 6 in class II and 4 in class III. The other 7 non-catheterized patients were in class II. There were resting peak systolic gradients of 15 to 35 mmHg in 4, 36 to 55 mmHg and more than 55 mmHg across the xenograft valve and the proximal anastomosis in 4 other patients. The right and left ventricular end-diastolic pressures (RVEDP, LVEDP) averaged 18 and 17.5 mmHg, respectively, in 3 patients. The mean ratio of PRV/PLV quotient in NYHA class I group was 0.3, in class II 0.45 to 0.7 and in class III greater than 0.7 (including 2 with residual VSD and pulmonary hypertension). Late densitometric studies for assessing pulmonary valve competence revealed regurgitant fraction of up to 40% of the total stroke volume in the absence of a residual shunt 2 to 4 years after conduit implantation. Three children underwent uneventful surgical replacement of calcified xenograft conduit 1 1/2 to 4 1/2 years after surgery with antibiotic-sterilized valve allograft. Four other patients have residual ventricular septal defects (VSD), 2 of them underwent surgical reclosure while the other 2 patients with pulmonary hypertension still have their residual VSD open.(ABSTRACT TRUNCATED AT 400 WORDS) SN - 0171-6425 UR - https://www.unboundmedicine.com/medline/citation/6207617/Late_results_of_valve_xenograft_conduits_between_the_right_ventricle_and_the_pulmonary_arteries_in_patients_with_pulmonary_atresia_and_extreme_tetralogy_of_Fallot_ L2 - http://www.thieme-connect.com/DOI/DOI?10.1055/s-2007-1023396 DB - PRIME DP - Unbound Medicine ER -