Document Detail


Perimount bovine pericardial valve to restore pulmonary valve competence late after right ventricular outflow tract repair.
MedLine Citation:
PMID:  18377487     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: No ideal option exists for restoring pulmonary valve competence late after repair of the congenitally abnormal right ventricular outflow tract (RVOT). This has driven a continued search for new alternatives. Texas Children's Hospital has recently used the Carpentier-Edwards Perimount RSR Pericardial Aortic Prosthesis (Edwards Lifesciences, Irvine, Calif, USA) for this indication and reports the initial experience.
DESIGN: Retrospective chart review.
SETTING: Academically affiliated tertiary-care pediatric hospital.
PATIENTS: Twenty-six patients who underwent pulmonary valve replacement with the Perimount valve late after RVOT reconstruction between June 2002 and November 2005.
INTERVENTIONS: No prospective interventions.
OUTCOMES MEASURES: Hospital morbidity and mortality. Valve function assessed by follow-up visits and echocardiograms.
RESULTS: Mean age and weight of the patients were 20.3 +/- 9.8 years (range 7.0-45.1 years) and 56.2 +/- 18.1 kg (range 35.8-109 kg). Twenty-two patients (85%) had severe pulmonary insufficiency (PI), 23 (89%) had symptomatic right heart failure, and 14 (54%) had moderate to severe right ventricular dysfunction. Average prosthetic valve size was 23 mm (range 19-27 mm). Twenty-one (88%) patients were extubated within 24 hours. There was no hospital mortality. Median length of stay for all patients from day of surgery was 6 days (range 3-56 days). Median length of last echocardiography follow-up was 12.4 months (range 0.1-37.6 months). At that time, 16 of the 26 (62%) patients had improved right ventricular function, no patient demonstrated significant RVOT obstruction, and 24 patients (92%) have no PI or mild PI. Freedom from death, reintervention, or reoperation on the pulmonary valve is 100% at 2.5 years.
CONCLUSION: Initial results with the Perimount bovine pericardial tissue prosthesis for pulmonary valve replacement are encouraging. Further follow-up is required to define long-term function and durability.
Authors:
David L S Morales; Brandi E Braud; Daniel J DiBardino; Kathleen E Carberry; E Dean McKenzie; Jeffrey S Heinle; Charles D Fraser
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Congenital heart disease     Volume:  2     ISSN:  1747-0803     ISO Abbreviation:  Congenit Heart Dis     Publication Date:    2007 Mar-Apr
Date Detail:
Created Date:  2008-04-01     Completed Date:  2008-06-19     Revised Date:  2011-05-05    
Medline Journal Info:
Nlm Unique ID:  101256510     Medline TA:  Congenit Heart Dis     Country:  United States    
Other Details:
Languages:  eng     Pagination:  115-20     Citation Subset:  IM    
Affiliation:
Michael E. DeBakey Department of Surgery, Division of Congenital Heart Surgery, Baylor College of Medicine, Houston, TX 77030, USA. dlmorale@texaschildrenshospital.org
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MeSH Terms
Descriptor/Qualifier:
Animals
Aortic Valve
Bioprosthesis*
Cattle
Cohort Studies
Heart Valve Prosthesis*
Heart Valve Prosthesis Implantation*
Humans
Length of Stay
Pericardium*
Pulmonary Valve / physiopathology,  surgery*
Retrospective Studies
Treatment Outcome
Ventricular Outflow Obstruction / physiopathology*,  surgery*

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


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