Right Ventricular Outflow Tract Reconstruction with Bicuspid.
- Author:
Jung Chul KIM
1
;
Sung Yeol HYUN
;
Sang Ik KIM
;
Chul Hyun PARK
;
Kook Yang PARK
Author Information
1. Department of Thoracic and Cardiovascular Surgery, Heart center, Gil Hospital, Gachon Medical College. JC2580@ghil.com
- Publication Type:Original Article
- Keywords:
Transplantation, homologous;
Ventricular outflow tract reconstruction, right;
bioprosthesis
- MeSH:
Allografts;
Bicuspid*;
Bioprosthesis;
Female;
Follow-Up Studies;
Heart;
Hemodynamics;
Humans;
Infant;
Mental Competency;
Tetralogy of Fallot;
Transplantation;
Transplantation, Homologous
- From:The Korean Journal of Thoracic and Cardiovascular Surgery
1999;32(11):1042-1045
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUND: Recently, open heart surgerys using homograft are progressively increasing in complex cardiac anomalies, and even though the use of homograft tissues harvested from hearts of transplant recipients and brain-death patients are allowed and their use is increasing, the supply of homograft tissue is very limited. MATERIAL AND METHOD: The large diameter homografts are difficult to apply directly for RVOT reconstruction of small neonatal and infant hearts due to the size mismatching. Therefore, were surgically down-sized the large diameter tricuspid homograft into bicuspid conduits by means of a longitudinal incision of the oversized homograft, excision of one cusp, and oversewing of the"Bicuspid homograft"wrapped around a Hega dilator of the appropriate size. RESULT: 3 patients(Male 1, Female 2: tetralogy of Fallot with pulmonary atresia), ranging in age from 5 months to 4 years and ranging in weight from 5.5Kg to 12.95Kg underwent reconstruction of the RVOT with bicuspid conduits obtained by appropriate tailoring from large-diameter homografts. The mean follow-up period was 4.3 months(range, 2 to 6 months). There were no complications related to the homograft tissues. CONCLUSION: In the short term follow-up, the bicuspid homografts provided good competence and excellent hemodynamics although a long term follow-up is needed to assess the functions of the bicuspid homografts in RVOT. We believe this technique may be a more effective alternative than the use of synthetic conduits when the use of an appropriate-sized homograft is not possible.
