Twenty-one Year Experience with Right Ventricle to Pulmonary Artery Conduit Interposition.
- Author:
Jae Gun KWAK
1
;
Jae Suk YOO
;
Yong Jin KIM
;
Woong Han KIM
;
Jeong Ryul LEE
Author Information
1. Department of Thoracic and Cardiovascular Surgery, Sejong General Hospital, Korea.
- Publication Type:Original Article
- Keywords:
Conduits;
Rastelli operation;
Pulmonary atresia;
Tetralogy of Fallot
- MeSH:
Body Weight;
Follow-Up Studies;
Heart Diseases;
Heart Ventricles;
Humans;
Polyethylene Terephthalates;
Polytetrafluoroethylene;
Pulmonary Artery;
Pulmonary Atresia;
Reoperation;
Retrospective Studies;
Tetralogy of Fallot;
Transplantation, Homologous;
Transplants
- From:The Korean Journal of Thoracic and Cardiovascular Surgery
2008;41(4):417-422
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUND: The aim of this study is to evaluate the long term results of creating various right ventricle to pulmonary artery conduits for treating complex congenital heart disease. MATERIAL AND METHOD: Between June 1986 and July 2006, we retrospectively reviewed 245 patients who underwent reconstruction of the right ventricular outflow tract with various kinds of conduits. 410 operations were done in 245 patients, the mean age at operation was 3.2+/-4.9 years (range: 7 days~45 years) and the mean body weight was 12.5+/-8.7 kg (range: 2.4~76.3 kg). RESULT: We used the following conduits: Polystan conduit, Shelhigh conduit, Carpenter-Edward conduit, Dacron graft with an artificial valve, valveless Gore Tex vascular graft, homograft and hand-made bovine or autologous pericardial conduit. The mean follow up duration was 6.3+/-5.2 years. Redo operation for RV-PA conduit dysfunction was performed in 131 patients, a second redo was done in 31 and a third redo was done in 3. The reoperation free rates were 67.3%, 48.5% and 39.4% for 5 years, 10 years and 15 years, respectively. The homograft showed the best durability, followed by the Dacron graft with artificial valve and the Carpentier-Edward conduit. The larger sized conduit showed better durability. CONCLUSION: The homograft showed lowest reoperation rate and a smaller size of conduit showed the highest reoperation rate. The reoperation rate for the RV-PA conduit was about 35% at 5 years, so it is mandatory to develop the more durable conduit for RV outflow.
