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Right arrow Congenital - cyanotic

Ann Thorac Surg 2002;74:127-132
© 2002 The Society of Thoracic Surgeons

Original article: cardiovascular

Intermediate follow-up of a composite stentless porcine valved conduit of bovine pericardium in the pulmonary circulation

Bertrand Aupècle, MDa, Alain Serraf, MD, PhD*a, Emre Belli, MDa, Siamak Mohammadi, MDa, François Lacour-Gayet, MDa, Paul Fornes, MDb, Claude Planché, MDa

a Department of Pediatric Cardiac Surgery, Hospital Marie-Lannelongue, Paris Sud University, Le Plessis Robinson, France
b Department of Anatomic Pathology, European Hospital Georges Pompidou, Paris, France

Accepted for publication March 25, 2002.

* Address reprint requests to Dr Serraf, Service de Chirurgie des Cardiopathies Congénitales (Pr Planché), Centre Chirurgical Marie Lannelongue, 133 ave de la Résistance, Le Plessis Robinson 92350, France
e-mail: aserraf{at}ccml.com

Background. In the pediatric population, glutaraldehyde-preserved bovine pericardium conduit containing a stentless porcine valve has been proposed as an alternative to homografts for right ventricular outflow tract reconstruction.

Methods. Between June 1996 and March 2000, a total of 55 patients, 20 with truncus arteriosus, 21 with pulmonary atresia with ventricular septal defect, and 14 with miscellaneous defects, received this conduit. Median age at implantation was 3.4 months (range, 3 days to 19 years), and 27 patients (50%) were less than 3 months old. Clinical outcome, echocardiographic data, and pathologic analysis were recorded. End points for conduit failure were conduit replacement or dilation. A mean follow-up of 27 months (range, 2 to 46 months) was available for 47 survivors.

Results. Procedure for conduit obstruction was required in 13 patients. The most common procedure was operation, and all but 3 patients had an unsuccessful balloon angioplasty before reoperation. Actuarial freedom from conduit dilation or reoperation was 93.6% (95% confidence limits, 82% to 99%), 81.9% (95% confidence limits, 64% to 91%), 77.8% (95% confidence limits, 39% to 78%), and 64.3% (95% confidence limits, 26% to 73%) at 1, 2, 3, and 4 postoperative years, respectively. Univariate analysis identified small conduit size as a risk factor for conduit obstruction.

Conclusions. Although this new conduit was not free from progressive obstruction, our clinical results (easy to work and good valvular function) and the availability in small sizes encouraged us to use it as an alternative to small-size homografts when those were not available.




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