Ann Thorac Surg 1978;25:358-363
© 1978 The Society of Thoracic Surgeons
A New Prosthesis for Reconstruction of the Left Ventricular Outflow Tract
William S. Pierce, M.D.*,
John A. Waldhausen, M.D.,
James H. Donachy,
Victor Whitman, M.D.
Departments of Surgery and Pediatrics, College of Medicine and The Milton S. Hershey Medical Center of The Pennsylvania State University, Hershey, PA.
Accepted for publication April 1, 1977.
* Address reprint requests to Dr. Pierce, Division of Car-diothoracic Surgery, Department of Surgery, The Milton S. Hershey Medical Center, The Pennsylvania State University, Hershey, PA 17033
A new left ventricular outflow tract prosthesis is described. It consists of a tightly woven Dacron graft with one end modified by being wrapped around a thin perforated stainless steel tube to form a rigid left ventricular insertion port and the other end anastomosed to a Hancock xenograft valved conduit for suture to the arterial system. The prosthesis is simple in design and flexible enough to permit anastomosis to any portion of the abdominal aorta. In addition, since the entire blood conduit consists of a porous woven arterial graft and a tissue valve, anticoagulants are not required. The prosthesis has been successfully employed in a 7-year-old boy who had undergone two previous open-heart operations for resection of a subaortic ring but who had persistent evidence of severe residual stenosis. We believe this conduit has advantages over present commercially available units.
- Bernhard WF, Keane JF, Fellows CE, et al. Progress and problems in the surgical management of congenital aortic stenosis J Thorac Cardiovasc Surg 1973;66:404.[Medline]
- Bernhard WF, Poirier V, Carr JG. A new method for temporary left ventricular bypass J Thorac Cardiovasc Surg 1975;70:880.[Abstract]
- Bernhard WF, Poirier V, LaFarge CG. Relief of congenital obstruction to left ventricular outflow with a ventricular-aortic prosthesis J Thorac Cardiovasc Surg 1975;69:223.[Abstract]
- Bowman FD, Hancock WD, Malm JR. A valve-containing Dacron prosthesis: its use in restoring pulmonary artery-right ventricular continuity Arch Surg 1973;107:724.[Medline]
- Brown JW, Myerowitz PD, Cann MS, et al. Apical-aortic anastomosis: a method for relief of diffuse left ventricular outflow obstruction Surg Forum 1974;25:147.[Medline]
- Cooley DA, Hallman GL. Surgical Treatment of Congenital Heart Disease. Philadelphia: Lea & Febiger; 1966.
- Dembitsky WP, Weldon CS. Clinical experience with a valve-bearing conduit to construct a second left ventricular outflow tract in cases of unresectable intraventricular obstruction Ann Surg 1976;184:317.[Medline]
- Kelly DT, Wulfsberg BA, Rowe RD. Discrete subaortic stenosis Circulation 1972;46:309.[Abstract/Free Full Text]
- Mair DD, Ritter DG, Davis GD, et al. Selection of patients with truncus arteriosus for surgical correction Circulation 1974;49:144.[Abstract/Free Full Text]
- Norman JC, Nihill MR, Cooley DA. Creation of double-outlet left ventricles for left ventricular outflow obstructions: initial clinical results in six patients Trans Am Soc Artif Intern Organs 1976;22:332.[Medline]
- Pierce WS, Brighton JA, O'Bannon W, et al. Complete left ventricular bypass with a paracorporeal pump: design and evaluation Ann Surg 1974;180:418.[Medline]
- Pierce WS, Thompson WM, Kazama S, et al. Replacement of the pulmonary outflow tract and valve with a formalin-treated porcine heterograft J Thorac Cardiovasc Surg 1971;61:924.[Medline]
- Reis RL, Peterson LM, Mason DT, et al. Congenital fixed subvalvular aortic stenosis: an anatomical classification and correlations with operative results Circulation 1971;43(Suppl 1):1144:.[Free Full Text]
- Robinson W, Daly B, Hughes D, et al. An abdominal left ventricular assist device: preclinical studies Ann Thorac Surg 1975;19:540.[Abstract/Free Full Text]
- Sarnoff SJ, Donovan TJ, Case RB. The surgical relief of aortic stenosis by means of apical-aortic valvular anastomosis Circulation 1955;11:564.[Abstract/Free Full Text]
- Wallace RB. Tissue valves Am J Cardiol 1975;35:867.
- Zuhdi N. The porcine aortic valve bioprosthesis: a significant alternative Ann Thorac Surg 1976;21:573.[Free Full Text]