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Ann Thorac Surg 1979;27:426-434
© 1979 The Society of Thoracic Surgeons

Articles

Long-Term Sequential Hemodynamic Evaluation of Right Ventricular Outflow Tract Reconstruction Using a Valve Mechanism

Marian I. Ionescu, M.D.*, Anand P. Tandon, M.R.C.P., Fergus J. Macartney, F.R.C.P.

Departments of Cardiothoracic Surgery and Cardiology, The General Infirmary at Leeds, and Department of Pediatric Cardiology, Hospital for Sick Children, London, England

Accepted for publication September 14, 1978.

* Address reprint requests to Dr. Ionescu, Department of Cardiothoracic Surgery, The General Infirmary, Great George St, Leeds, LS1 3EX, England

From May, 1972, to May, 1978, right ventricular outflow tract reconstruction was performed in 20 patients with congenital heart disease. A monocusp patch constructed entirely of glutaraldehyde-stabilized calf pericardium, was employed in 19 patients, and a composite conduit consisting of a three-cusp pericardial xenograft valve in a Dacron tube was used in 1 patient.

There were 2 hospital deaths (10%) and no late deaths. The follow-up ranged from 5 to 75 months (mean, 55.7 ± 4.6 months; total, 1,002 patient months). Eleven patients had completed 5 years of follow-up at the time of writing.

Hemodynamic studies were performed in 10 patients at an average of 40 months after operation and the right ventricle-pulmonary artery systolic gradient was 9.3 ± 1.7 mm Hg. This was not significantly different in 6 patients who had a second postoperative catheterization at 51.8 ± 2.0 months following operation. Angiography showed fully mobile, thin valve cusps.

These results compare well with those reported with other types of conduits, particularly with reference to relief of obstruction.




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