Document Detail


Early and midterm results of an alternative procedure to homografts in primary repair of truncus arteriosus communis.
MedLine Citation:
PMID:  20576045     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Repair of truncus arteriosus communis (TAC) in the neonatal and early infant period has become a standard practice. We report our experience on primary repair of TAC with a bovine pericardial-valved woven Dacron conduit as an alternative procedure to homografts, with a focus on early and midterm results. METHODS: From January 2001 to December 2007, 15 patients with mean age 1.5 years (range 3 months to 8 years), underwent primary repair of simple TAC. Cases with cardiogenic shock, complex-associated cardiac lesions, or adverse anatomy of the truncal valve were excluded. The Collett and Edwards anatomical type classification of TAC was as follows: type I, 13 (87%); and type II, 2 (13%). Right ventricular outflow tract was reconstructed in all the cases with a bovine pericardial-valved woven Dacron conduit. RESULTS: Overall mortality was 6.6% (1 death due to severe pulmonary hypertension). At a mean follow-up of 31 months (range 6-51), there were no deaths (5-year actuarial survival 93.4%). Out of the 14 midterm survivors, three developed stenosis of the pericardial-valved woven Dacron conduit, but only one underwent interventional procedure including percutaneous balloon dilation with stenting for associated left pulmonary artery hypoplasia. The rate of patients with no surgical or percutaneous reinterventions performed because of obstruction of the right ventricular outflow tract reconstruction in the midterm (5 years) was 86%. CONCLUSIONS: Truncus arteriosus communis repair with a bovine pericardial-valved woven Dacron conduit can be performed with a very low perioperative mortality and satisfactory midterm morbidity, favorably compared with that reported for the use of homografts. Interventional cardiac catheterization may delay the time of reoperation for inevitable conduit replacement due to stenosis.
Authors:
Pedro Curi-Curi; Jorge Cervantes; Mauricio Soulé; Julio Erdmenger; Juan Calderón-Colmenero; Samuel Ramírez
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Congenital heart disease     Volume:  5     ISSN:  1747-0803     ISO Abbreviation:  Congenit Heart Dis     Publication Date:    2010 May-Jun
Date Detail:
Created Date:  2010-06-25     Completed Date:  2010-10-12     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101256510     Medline TA:  Congenit Heart Dis     Country:  United States    
Other Details:
Languages:  eng     Pagination:  262-70     Citation Subset:  IM    
Affiliation:
Department of Pediatric Cardiac Surgery and Congenital Heart Disease, Ignacio Chavez National Cardiology Institute of México, Mexico City, Mexico. pcuricuri@gmail.com
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MeSH Terms
Descriptor/Qualifier:
Angioplasty, Balloon / instrumentation
Animals
Bioprosthesis*
Blood Vessel Prosthesis*
Blood Vessel Prosthesis Implantation / adverse effects,  instrumentation*,  mortality
Cardiac Surgical Procedures / adverse effects,  instrumentation*,  mortality
Cattle
Child
Child, Preschool
Heart Defects, Congenital / mortality,  surgery*
Humans
Kaplan-Meiers Estimate
Mexico
Pericardium / transplantation*
Polyethylene Terephthalates
Prosthesis Design
Reoperation
Retrospective Studies
Stents
Time Factors
Treatment Outcome
Truncus Arteriosus / abnormalities,  surgery*
Chemical
Reg. No./Substance:
0/Polyethylene Terephthalates

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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