Abstract
Purpose
Generally, right ventricular outflow tract reconstruction in adults is performed using homografts or xenograft. However, sufficient graft material is difficult to obtain and has the problems of calcification and structure destruction. We, therefore, evaluated using expanded polytetrafluoroethylene- (ePTFE)-valved conduits with bulging sinuses for right ventricular outflow tract reconstruction in adults.
Methods
Between February 2006 and April 2008, a total of five patients (three men, two women), ages 25–51 years old (mean ± SD, 40 ± 11 years)] underwent right ventricular outflow tract (RVOT) reconstruction in our institution. In three patients, RVOT reconstruction was performed with the Ross procedure; and in all cases, tricuspid ePTFE (valved conduits with bulging sinuses were used. The diameter of the conduit was determined according to the RVOT size. Valve function was followed up using echocardiography after surgery and during the early/mid-term periods of recovery (13 months to 3.0 years).
Results
No morbidity occurred, and no patient required further surgery during the follow-up period. During these follow-up periods, pulmonary observation revealed that no patients had stenosis; regurgitation was mild in one patient and trivial in four patients. In regard to the tricuspid valve, regurgitation was trivial in four patients and mild in one patient.
Conclusion
Although long-term follow-up is required to confirm the durability of the ePTFE-valved conduit with bulging sinuses, the present results indicate a satisfactory result in patients who undergo RVOT reconstruction, even in adult cases.
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References
Gulbins H, Kreuzer E, Reichart B. Homografts: a review. Expert Rev Cardiovasc Ther 2003;1:533–539.
Meyns B, Van Garsse L, Boshoff D, Eyskens B, Mertens L, Gewillig M, et al. The Contegra conduit in the right ventricular outflow tract induces supravalvular stenosis. J Thorac Cardiovasc Surg 2004;128:834–840.
Boudjemline Y, Bonnet D, Massih TA, Agnoletti G, Iserin F, Jaubert F, et al. Use of bovine jugular vein to reconstruct the right ventricular outflow tract: early results. J Thorac Cardiovasc Surg 2003;126:490–497.
Bilal MS, Aydemir NA, Cine N, Turan T, Yildiz Y, Yalcin Y, et al. Intermediate-term results of Medtronic freestyle valve for right ventricular outflow tract reconstruction in the Ross procedure. J Heart Valve Dis 2006;15:696–701.
Miyazaki T, Yamagishi M, Nakashima A, Fukae K, Nakano T, Yaku H, et al. Expanded polytetrafluoroethylene valved conduit and patch with bulging sinuses in right ventricular outflow tract reconstruction. J Thorac Cardiovasc Surg 2007;134:327–332.
Mohammadi S, Belli E, Martinovic I, Houyel L, Capderou A, Petit J, et al. Surgery for right ventricle to pulmonary artery conduit obstruction: risk factors for further reoperation. Eur J Cardiothorac Surg 2005;28:217–222.
Boethig D, Thies WR, Hecker H, Breymann T. Mid term course after pediatric right ventricular outflow tract reconstruction: a comparison of homografts, porcine xenografts and Contegras. Eur J Cardiothorac Surg 2005;27:58–66.
Novick WM, Anic D, Lora Solf A, Arboleda Torres M, Nino De Guzman Leon I, Reid RW, et al. Medtronic Freestyle valve for right ventricular reconstruction in pediatric Ross operations. Ann Thorac Surg 2004;77:1711–1716.
Bohm JO, Botha CA, Hemmer W, Starck C, Blumenstock G, Roser D, et al. Older patients fare better with the Ross operation. Ann Thorac Surg 2003;75:796–801; discussion 802.
Fullerton DA, Fredericksen JW, Sundaresan RS, Horvath KA. The Ross procedure in adults: intermediate-term results. Ann Thorac Surg 2003;76:471–476; discussion 476–7.
Gott JP, Pan C, Dorsey LM, Jay JL, Jett GK, Schoen FJ, et al. Calcification of porcine valves: a successful new method of antimineralization. Ann Thorac Surg 1992;53:207–215; discussion 216.
Kanter KR, Budde JM, Parks WJ, Tam VK, Sharma S, Williams WH, et al. One hundred pulmonary valve replacements in children after relief of right ventricular outflow tract obstruction. Ann Thorac Surg 2002;73:1801–1806; discussion 1806–7.
Tsukube T, Kawanishi Y, Murakami H, Hino Y, Matsukawa R, Ozaki N, et al. Reconstruction of right ventricular outflow tract with stentless xenografts in Ross procedure. Artif Organs 2002;26:1055–1059.
Yamagishi M, Kurosawa H, Nomura K, Kitamura N. Fanshaped expanded polytetrafluoroethylene valve in the pulmonary position. J Cardiovasc Surg (Torino) 2002;43:779–786.
Turrentine MW, McCarthy RP, Vijay P, McConnell KW, Brown JW. PTFE monocusp valve reconstruction of the right ventricular outflow tract. Ann Thorac Surg 2002;73:871–879; discussion 879–80.
Kunzelman KS, Grande KJ, David TE, Cochran RP, Verrier ED. Aortic root and valve relationships: impact on surgical repair. J Thorac Cardiovasc Surg 1994;107:162–170.
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Takahashi, Y., Tsutsumi, Y., Monta, O. et al. Expanded polytetrafluoroethylene-valved conduit with bulging sinuses for right ventricular outflow tract reconstruction in adults. Gen Thorac Cardiovasc Surg 58, 14–18 (2010). https://doi.org/10.1007/s11748-009-0527-9
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DOI: https://doi.org/10.1007/s11748-009-0527-9