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Ann Thorac Surg 2005;79:2203
© 2005 The Society of Thoracic Surgeons

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Correspondence

Reply

Division of Cardiothoracic Surgery, Emory University School of Medicine, 1365 Clifton Rd, Atlanta, GA 30322

(E-mail: kkanter{at}emory.edu).

To the Editor:

As pointed out in our study in The Annals [1], we too, are concerned about the development of right ventricular outflow tract obstruction with the Freestyle valve. In our series, the average gradient across the right ventricular outflow tract at a mean follow-up of 2.5 years was 19.7 ± 15.4 mm Hg. Since the publication of this report, we have inserted a Freestyle porcine valve in the pulmonary position in an additional 18 children without incident. With an average follow-up now of almost 3 years, we still have not found it necessary to explant any valve for stenosis other than the one in the patient mentioned in the study. We remain concerned about the development of ongoing right ventricular outflow tract obstruction and will watch these patients closely. We still think that the advantage of the Freestyle porcine aortic root in the pulmonary position is the low incidence of pulmonary insufficiency as opposed to the homograft valve, which often develops pulmonary insufficiency early [2].

Clearly, there is yet no perfect valve available for reconstruction of the right ventricular outflow tract in children. We are cautiously optimistic about the Freestyle porcine root but need a longer follow-up to make a definitive statement.

	References

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1. Kanter KR, Fyfe DA, Mahle WT, Forbess JM, Kirshbom PM. Results with the Freestyle porcine aortic root for right ventricular outflow tract reconstruction in children Ann Thorac Surg 2003;76:1889-1895.[Abstract/Free Full Text]
2. Kanter KR, Budde JM, Parks WJ, et al. One hundred pulmonary valve replacements in children after relief of right ventricular outflow tract obstruction Ann Thorac Surg 2002;73:1801-1807.[Abstract/Free Full Text]

This Article Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Kirk R. Kanter Permission Requests Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Kanter, K. R. Search for Related Content PubMed Articles by Kanter, K. R. Related Collections Congenital - acyanotic Related Article