Document Detail

Fate of small homograft conduits after early repair of truncus arteriosus.
MedLine Citation:
PMID:  8512389     Owner:  NLM     Status:  MEDLINE    
Neonatal repair of truncus arteriosus is being performed in a number of centers, often with the use of small homograft conduits. The fate of the homograft and the risk of replacement were the subjects of this study. Between January 1987 and October 1991, 43 infants aged less than 3 months (range, 3 to 90 days) underwent primary repair of truncus arteriosus including implantation of a valved homograft conduit (diameter, 7 to 12 mm). Twenty-nine had follow-up of more than 6 months (range, 6 to 65 months; mean, 21.9 months). After a mean period of 31 months (range, 8 to 65 months), 7 patients showed obstruction with right ventricular pressures at least 75% systemic and underwent either a conduit change (n = 5) or a patch augmentation (n = 2). Mean cardiopulmonary bypass time at reoperation was 99 minutes; mortality was zero. Five other children are known to have a right ventricular pressure of 50% to 60% systemic, 2 having undergone balloon dilation. Statistical comparison of the patients with conduit reoperation or high right ventricular pressure (n = 12) with the rest of the population (n = 17) revealed an elevated pulmonary artery to right ventricular pullback gradient on postoperative day 1 after the repair (7.7 versus 1.3 mm Hg; p = 0.001) and choice of an aortic over a pulmonary homograft (100% versus 64.7%; p = 0.065) as significant risk factors. Age and weight at repair, postoperative pulmonary artery pressure, length of follow-up, and size of the homograft showed no significant differences between the two groups.(ABSTRACT TRUNCATED AT 250 WORDS)
M K Heinemann; F L Hanley; K N Fenton; R A Jonas; J E Mayer; A R Castaneda
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The Annals of thoracic surgery     Volume:  55     ISSN:  0003-4975     ISO Abbreviation:  Ann. Thorac. Surg.     Publication Date:  1993 Jun 
Date Detail:
Created Date:  1993-07-13     Completed Date:  1993-07-13     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  15030100R     Medline TA:  Ann Thorac Surg     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1409-11; discussion 1411-2     Citation Subset:  AIM; IM    
Department of Cardiac Surgery, Children's Hospital, Harvard Medical School, Boston, Massachusetts.
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MeSH Terms
Aorta / transplantation*
Blood Vessel Prosthesis*
Follow-Up Studies
Graft Occlusion, Vascular / epidemiology*,  surgery
Infant, Newborn
Pulmonary Artery / transplantation*
Risk Factors
Time Factors
Truncus Arteriosus, Persistent / epidemiology,  surgery*

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