Document Detail


Performance of bicuspidized pulmonary allografts compared with standard trileaflet allografts.
MedLine Citation:
PMID:  20667359     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Pulmonary allografts are commonly used in the reconstruction of the right ventricular outflow tract. However, in pediatric patients, allografts that are small enough are often unavailable. To downsize larger, more readily available conduits, one leaflet can be excised, forming a bicuspid valve. The aim of this study was to assess the intermediate-term durability of bicuspidized allografts compared with standard allografts. METHODS: Forty-seven patients who received a bicuspidized allograft from 1998 to 2008 were compared with 51 patients who received a standard allograft during the same time period. Outcome measures included need for and timing of reintervention, degree of pulmonary stenosis, insufficiency at most recent follow-up, and survival. RESULTS: On average, the bicuspidized allograft patients were younger, weighed less, and received smaller valves more frequently placed in a heterotopic position than the standard allograft patients. The mean peak gradient across the conduit and the degree of pulmonary insufficiency at discharge were similar between the comparison groups. No statistical differences in need for or timing of reintervention were observed between the surgical groups. CONCLUSIONS: Bicuspidized allografts performed similarly to that of standard allografts with regard to the need for reintervention, the development of stenosis or regurgitation, and patient survival. Based on this patient sample, the bicuspidized allograft technique appears to provide an excellent option to expand the availability of small-sized allografts for the reconstruction of the right ventricular outflow tract.
Authors:
Terry Shih; James G Gurney; Edward L Bove; Eric J Devaney; Jennifer C Hirsch; Richard G Ohye
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  The Annals of thoracic surgery     Volume:  90     ISSN:  1552-6259     ISO Abbreviation:  Ann. Thorac. Surg.     Publication Date:  2010 Aug 
Date Detail:
Created Date:  2010-07-29     Completed Date:  2010-08-24     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  15030100R     Medline TA:  Ann Thorac Surg     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  610-3     Citation Subset:  AIM; IM    
Copyright Information:
Copyright 2010 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.
Affiliation:
Division of Pediatric Cardiovascular Surgery, University of Michigan Medical School, Ann Arbor, MI 48109, USA. tyshih@umich.edu
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MeSH Terms
Descriptor/Qualifier:
Cardiac Surgical Procedures / methods
Child, Preschool
Female
Heart Defects, Congenital / surgery*
Heart Valves / transplantation
Humans
Male
Pulmonary Valve / surgery*,  transplantation
Retrospective Studies
Time Factors

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


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