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Ann Thorac Surg 1981;31:437-443
© 1981 The Society of Thoracic Surgeons

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Articles

Late Results of Reconstruction of the Right Ventricular Outflow Tract with Porcine Xenografts in Children

Departments of Pediatric Cardiology and Cardio-Thoracic Surgery, Children's Hospital Medical Center, Cincinnati, OH

Accepted for publication September 29, 1980.

^* Address reprint requests to Dr. Schwartz, Division of Pediatric Cardiology, Children's Hospital Medical Center, Elland and Bethesda Aves, Cincinnati, OH 45229

Thirty-three children, aged 2.5 to 17.5 years (mean, 8.3 years), having xenograft external conduits placed between the right ventricle and pulmonary artery were followed for 1 to 6 years postoperatively (mean, 3.5 years). There were no late deaths in the study group, and no infection of a valved conduit has been demonstrated. Twenty of these children were catheterized during the follow-up period. The gradients from the right ventricle to pulmonary artery ranged from 8 to 90 mm Hg (average, 31 mm Hg). A total of 8 patients were classified as having hemodynamically documented conduit failure, and an additional 2 patients are clinically expected to have conduit failure. This represents a total incidence of 30% xenograft conduit failure in a 6-year follow-up. Although the etiology of this dysfunction is probably multifactorial, factors such as valve size, conduit angulation, and immunological competence bear special consideration.

We conclude that although valved external conduits continue to play an important role in the treatment of complex congenital heart disease, a valved conduit with greater longevity is needed for use in children.

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