| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
|
|
|
|||||||
|
|||||||||
Ann Thorac Surg 2005;79:1662-1667
© 2005 The Society of Thoracic Surgeons
a Department of Pediatric Cardiothoracic Surgery, Wilhelmina Children's Hospital, Utrecht, The Netherlands
b Department of Cardiothoracic Surgery, German Heart Center at the Technical University Munich, Munich, Germany
Accepted for publication October 28, 2004.
* Address reprint requests to Dr Haas, Wilhelmina Children's Hospital, UMC Utrecht, Department of Pediatric Cardiothoracic Surgery, Room KG 01.319.0, PO Box 85090, 3508 AB Utrecht, The Netherlands (E-mail: f.haas{at}wkz.azu.nl).
BACKGROUND: The use of allografts or xenografts is the treatment of choice for pulmonary valve replacement. However, the limited durability is responsible for multiple reoperations associated with increased morbidity. In search of a definitive solution, the implantation of a mechanical valved conduit might be an option in highly selected patients. This study evaluated short-term results after pulmonary valve replacement with a mechanical valved conduit.
METHODS: Fourteen patients underwent pulmonary valve replacement with a mechanical valved conduit. All patients had a mean of 3.0 ± 1.2 previous operations. Seven patients were previously operated on for tetralogy of Fallot, 3 patients for pulmonary atresia, 3 patients for common arterial trunk, and 1 patient for subaortic stenosis.
RESULTS: All patients survived the operation and are currently well. At follow-up (11 to 63 months), all but 2 patients showed normal right ventricular function, with a mean gradient of 14 ± 9 mm Hg (range, 4 to 30 mm Hg) across the pulmonary valve. At follow-up, there was no evidence of valve failure or tissue growth within the valve annulus. All patients are receiving anticoagulants to maintain an international normalized ratio of 3.0 to 4.5.
CONCLUSIONS: In highly selected patients, the use of a mechanical valved conduit in the pulmonary position leads to satisfactory results. To avoid a predictable reoperation after multiple right ventricular outflow tract reconstruction, and therefore reoperation-related morbidity, the implantation of a mechanical prosthesis as a lifelong solution requires consideration. Selection criteria for this permanent solution should include older age, multiple previous operations, and patient compliance with anticoagulant therapy.
This article has been cited by other articles:
|
|
 |
|
  J. Horer, M. Vogt, U. Stierle, J. Cleuziou, Z. Prodan, C. Schreiber, and R. Lange A comparative study of mechanical and homograft prostheses in the pulmonary position. Ann. Thorac. Surg., November 1, 2009; 88(5): 1534 - 1539. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 O. Ghez, V. T. Tsang, A. Frigiola, L. Coats, A. Taylor, C. Van Doorn, P. Bonhoeffer, and M. De Leval Right ventricular outflow tract reconstruction for pulmonary regurgitation after repair of tetralogy of Fallot.: Preliminary results Eur. J. Cardiothorac. Surg., April 1, 2007; 31(4): 654 - 658. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
T. W. Waterbolk, E. S. Hoendermis, I. J. den Hamer, and T. Ebels Pulmonary valve replacement with a mechanical prosthesis. Promising results of 28 procedures in patients with congenital heart disease. Eur. J. Cardiothorac. Surg., July 1, 2006; 30(1): 28 - 32. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M.G. Hazekamp Editorial comment A mechanical prosthesis for pulmonary valve replacement? Eur. J. Cardiothorac. Surg., July 1, 2006; 30(1): 33 - 34. [Full Text] [PDF]
|
|
| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
| ANN THORAC SURG | ASIAN CARDIOVASC THORAC ANN | EUR J CARDIOTHORAC SURG |
| J THORAC CARDIOVASC SURG | ICVTS | ALL CTSNet JOURNALS |
