PMID- 6207617
OWN - NLM
STAT- MEDLINE
DCOM- 19841109
LR  - 20121115
IS  - 0171-6425 (Print)
IS  - 0171-6425 (Linking)
VI  - 32
IP  - 4
DP  - 1984 Aug
TI  - Late results of valve xenograft conduits between the right ventricle and the 
      pulmonary arteries in patients with pulmonary atresia and extreme tetralogy of 
      Fallot.
PG  - 250-2
AB  - Between 1975 and 1982, valve xenograft conduits were used to establish continuity 
      between the right ventricle and the pulmonary arteries in 28 patients between the 
      ages of 3 to 39 years (mean 14.7 years) with 4 hospital deaths (14%). The 
      indications for operation were pulmonary atresia types I and II in 7, extreme 
      tetralogy of Fallot with hypoplastic pulmonary artery and valvular ring in 10, 
      secondary obliteration of the infundibulum following Waterston shunt in 4, 
      pulmonary valve insufficiency after transannular right ventricular outflow tract 
      patch in 5 and tetralogy of Fallot with anomalous coronary artery in 2. 
      Twenty-one patients (87%) between 9 and 41 years of age (mean 17.4 years) were 
      available for follow-up 1/2 to 8 years after operation. The late death incidence 
      during the follow-up period was 8% (2/24). Postoperative cardiac catheterization, 
      which included right and left ventriculogram and measurements of gradients, was 
      performed in 14 patients 4 months to 6 years after operation. Four patients were 
      in New York Heart Association (NYHA) class 1, 6 in class II and 4 in class III. 
      The other 7 non-catheterized patients were in class II. There were resting peak 
      systolic gradients of 15 to 35 mmHg in 4, 36 to 55 mmHg and more than 55 mmHg 
      across the xenograft valve and the proximal anastomosis in 4 other patients. The 
      right and left ventricular end-diastolic pressures (RVEDP, LVEDP) averaged 18 and 
      17.5 mmHg, respectively, in 3 patients. The mean ratio of PRV/PLV quotient in 
      NYHA class I group was 0.3, in class II 0.45 to 0.7 and in class III greater than 
      0.7 (including 2 with residual VSD and pulmonary hypertension). Late 
      densitometric studies for assessing pulmonary valve competence revealed 
      regurgitant fraction of up to 40% of the total stroke volume in the absence of a 
      residual shunt 2 to 4 years after conduit implantation. Three children underwent 
      uneventful surgical replacement of calcified xenograft conduit 1 1/2 to 4 1/2 
      years after surgery with antibiotic-sterilized valve allograft. Four other 
      patients have residual ventricular septal defects (VSD), 2 of them underwent 
      surgical reclosure while the other 2 patients with pulmonary hypertension still 
      have their residual VSD open.(ABSTRACT TRUNCATED AT 400 WORDS)
FAU - Yankah, A C
AU  - Yankah AC
FAU - Lange, P E
AU  - Lange PE
FAU - Sievers, H H
AU  - Sievers HH
FAU - Radtke, W
AU  - Radtke W
FAU - Regensburger, D
AU  - Regensburger D
FAU - Heintzen, P H
AU  - Heintzen PH
FAU - Bernhard, A
AU  - Bernhard A
LA  - eng
PT  - Journal Article
PL  - Germany
TA  - Thorac Cardiovasc Surg
JT  - The Thoracic and cardiovascular surgeon
JID - 7903387
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - *Bioprosthesis
MH  - Cardiac Catheterization
MH  - Child
MH  - Child, Preschool
MH  - Follow-Up Studies
MH  - *Heart Valve Prosthesis
MH  - Hemodynamics
MH  - Humans
MH  - Postoperative Complications/mortality
MH  - Pulmonary Valve/*abnormalities
MH  - Pulmonary Valve Insufficiency/etiology
MH  - Stroke Volume
MH  - Tetralogy of Fallot/mortality/*surgery
MH  - Time Factors
EDAT- 1984/08/01 00:00
MHDA- 1984/08/01 00:01
CRDT- 1984/08/01 00:00
PHST- 1984/08/01 00:00 [pubmed]
PHST- 1984/08/01 00:01 [medline]
PHST- 1984/08/01 00:00 [entrez]
AID - 10.1055/s-2007-1023396 [doi]
PST - ppublish
SO  - Thorac Cardiovasc Surg. 1984 Aug;32(4):250-2. doi: 10.1055/s-2007-1023396.