Document Detail


Results with the freestyle porcine aortic root for right ventricular outflow tract reconstruction in children.
MedLine Citation:
PMID:  14667606     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: The ideal choice for valved reconstruction of the right ventricular outflow tract (RVOT) in children is undetermined. This study explores the Freestyle porcine aortic root for these patients. METHODS: From January 1998 to December 2002, 56 patients ages 1.6 to 29.9 years old (mean 11.8 years old) underwent RVOT reconstruction using a Freestyle porcine aortic root. The patients averaged 1.9 prior operations (range 0 to 5) for tetralogy of Fallot +/- pulmonary atresia (28 patients), critical pulmonary stenosis (10 patients), Ross procedure (5 patients), pulmonary atresia/intact ventricular septum (4 patients), complete atrioventricular septal defect +/- tetralogy of Fallot (4 patients), and others (5 patients). At time of RVOT reconstruction, 42 patients (75%) had additional procedures including the following: tricuspid or mitral repair (24 patients), pulmonary arterioplasty +/- Glenn (12 patients), ventricular septal defect closure (5 patients), aortic valve replacement (3 patients), placement of a cardioverter/defibrillator or pacemaker (3 patients), and others (8 patients). RESULTS: One patient developed mediastinitis; another was treated for Candida endocarditis (his excised homograft unexpectedly grew Candida). All patients are well on follow-up from 2 to 60 months (mean 30 +/- 20 months) with no deaths. The patient with endocarditis underwent conduit replacement for recurrent pulmonary stenosis 3.5 years postoperatively. Echocardiography revealed mild or no pulmonary insufficiency in 93%. The calculated mean peak systolic RVOT gradient by echocardiography was 19.7 +/- 15.4 mm Hg. CONCLUSIONS: These data demonstrate excellent results with the Freestyle bioprosthesis for RVOT reconstruction in children. This valve may serve as a readily available alternative to homograft valves in RVOT reconstruction, particularly since early insufficiency seems to be less problematic. Questions of long-term durability and significance of echocardiographic stenosis remain unanswered.
Authors:
Kirk R Kanter; Derek A Fyfe; William T Mahle; Joseph M Forbess; Paul M Kirshbom
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The Annals of thoracic surgery     Volume:  76     ISSN:  0003-4975     ISO Abbreviation:  Ann. Thorac. Surg.     Publication Date:  2003 Dec 
Date Detail:
Created Date:  2003-12-11     Completed Date:  2004-01-16     Revised Date:  2006-08-08    
Medline Journal Info:
Nlm Unique ID:  15030100R     Medline TA:  Ann Thorac Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1889-94; discussion 1894-5     Citation Subset:  AIM; IM    
Affiliation:
Division of Cardiothoracic Surgery, Department of Surgery, Atlanta, GA, USA. kkanter@emory.edu
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Aortic Valve*
Bioprosthesis*
Child
Child, Preschool
Heart Valve Prosthesis*
Heart Valve Prosthesis Implantation*
Humans
Infant
Pulmonary Artery / surgery
Pulmonary Valve / surgery
Ventricular Outflow Obstruction / complications,  surgery*
Comments/Corrections
Comment In:
Ann Thorac Surg. 2005 Jun;79(6):2202-3; author reply 2203   [PMID:  15919359 ]

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


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