Reconstruction of Right Ventricular Outflow Tract with Stentless Xenografts in Ross Procedure

2002 ◽  
Vol 26 (12) ◽  
pp. 1055-1059 ◽  
Author(s):  
Takuro Tsukube ◽  
Yujiro Kawanishi ◽  
Hirohisa Murakami ◽  
Yutaka Hino ◽  
Ritsu Matsukawa ◽  
...  
Keyword(s):  
Right Ventricular ◽  
Right Ventricular Outflow Tract ◽  
Ventricular Outflow Tract ◽  
Outflow Tract ◽  
Ross Procedure

scholarly journals Allografts and xenografts for right ventricular outflow tract reconstruction in Ross patients

2020 ◽  
Vol 59 (1) ◽  
pp. 162-169
Author(s):  
Ravil Sharifulin ◽  
Alexander Bogachev-Prokophiev ◽  
Igor Demin ◽  
Alexander Afanasyev ◽  
Mikhail Ovcharov ◽  
...  
Keyword(s):  
Propensity Score ◽  
Right Ventricular ◽  
Propensity Score Matching ◽  
Survival Rates ◽  
Right Ventricular Outflow Tract ◽  
Ventricular Outflow Tract ◽  
Outflow Tract ◽  
Long Term Results ◽  
Ross Procedure ◽  
Graft Dysfunction

Abstract OBJECTIVES Pulmonary allografts (AG) are the gold standard for right ventricular outflow tract (RVOT) reconstruction during the Ross procedure. However, there is limited availability of AG in some countries, and the use of alternative grafts for RVOT reconstruction remains controversial. This study aimed to compare the rates of freedom from RVOT graft dysfunction for AG and diepoxide-treated pericardial xenografts (DPXG). METHODS Between 1998 and 2015, 793 adult patients underwent the Ross procedure in our centre. Using propensity score matching, the clinical outcomes and echocardiographic results of AG and DPXG were compared. RESULTS Propensity score matching resulted in 2 groups (AG and DPXG) of 122 patients each. No difference was found in early mortality (2.5%) in both groups. The freedom from RVOT graft dysfunction curves were comparable between the AG and DPXG groups (P = 0.186) and the 8-year rates of freedom from graft dysfunction were 91.8% and 82.2%, respectively. The survival rates at 8 years were 90.5% and 90.1%, and the rates of freedom from RVOT reintervention at 8 years were 100% and 96.8% for the AG and DPXG groups, respectively. At discharge and follow-up, transprosthetic gradients were significantly higher in the DPXG group. The rate of the RVOT gradient progression was also higher in the DPXG group than in the AG group (1.80 ± 0.06 vs 1.39 ± 0.04 mmHg/year, P < 0.001). CONCLUSIONS There was no difference in freedom from RVOT graft dysfunction by 8 years when using AG and DPXG in adult Ross patients, nor in survival and freedom from RVOT conduit reintervention. Long-term results need further evaluation.

scholarly journals Mid-Term Pulmonary Homograft Function for Right Ventricular Outflow Tract Reconstruction in the Ross Procedure.

2002 ◽  
Vol 31 (6) ◽  
pp. 385-387
Author(s):  
Koji Nomura ◽  
Hiromi Kurosawa ◽  
Kiyozo Morita ◽  
Hirokuni Naganuma ◽  
Katsushi Kinouchi
Keyword(s):  
Right Ventricular ◽  
Right Ventricular Outflow Tract ◽  
Ventricular Outflow Tract ◽  
Outflow Tract ◽  
Ross Procedure ◽  
Pulmonary Homograft

scholarly journals Different conduits for the right ventricular outflow tract reconstruction in adults during the Ross procedure

2015 ◽  
Vol 17 (2) ◽  
pp. 23 ◽  
Author(s):  
A. M. Karaskov ◽  
I. I. Demin ◽  
R. M. Sharifulin ◽  
S. I. Zheleznev ◽  
A. V. Bogachev-prokofev ◽  
...  
Keyword(s):  
Right Ventricular ◽  
Multivariable Analysis ◽  
Right Ventricular Outflow Tract ◽  
Ventricular Outflow Tract ◽  
Outflow Tract ◽  
Ross Procedure ◽  
Acceptable Alternative ◽  
The Right ◽  
Pulmonary Homograft

We compared different conduits for the right ventricular outflow tract reconstruction (RVOT) in adults during the Ross procedure. Between 1998 and 2012, 586 consecutive adult patients underwent the Ross procedures. Mean age was 45,514,2 years. The RVOT was reconstructed with a diepoxy-treated xenografts in 372 and with glutaraldehyde-treated in 88 patients. A pulmonary homograft was used in 125 patients. Hospital mortality was 4,9%. Mean follow up was 43,216,9 months. At discharge systolic gradient was 8,1 3,7 mm.Hg for the pulmonary homograft, 11,44,7 mm.Hg for the diepoxytreated and 14,96,1 mm.Hg for the glutaraldehyde-treated xenopericardial conduits. Twenty eight patients underwent reoperation. The 3-year actuarial freedom from conduit explantation for pulmonary homograft was 100%, for diepoxy- and glutaraldehyde-treated xenopericardial conduits 99,20,7% and 84,74,7% respectively. Multivariable analysis identified the type of xenograft and age as independent factors for xenograft dysfunction. Results from this study show that the pulmonary homograft is the most preferred conduit for the RVOT reconstruction during the Ross procedure. The diepoxy-treated xenopericardial conduits are acceptable alternative to the homograft in patients older 45 years.

scholarly journals Fresh decellularized versus standard cryopreserved pulmonary allografts for right ventricular outflow tract reconstruction during the Ross procedure: a propensity-matched study†

2018 ◽  
Vol 54 (3) ◽  
pp. 434-440 ◽  
Author(s):  
Jonathan Richard Gregory Etnel ◽  
Paula Hansen Suss ◽  
Gabriela Miotto Schnorr ◽  
Myriam Veloso ◽  
Daniele Fornazari Colatusso ◽  
...  
Keyword(s):  
Right Ventricular ◽  
Right Ventricular Outflow Tract ◽  
Ventricular Outflow Tract ◽  
Outflow Tract ◽  
Ross Procedure ◽  
Matched Study

scholarly journals RIGHT VENTRICULAR OUTFLOW TRACT RECONSTRUCTION DURING THE ROSS PROCEDURE: COMPARISON OF PULMONARY ALLOGRAFTS AND PERICARDIAL XENOGRAFTS

2018 ◽  
Vol 7 (2) ◽  
pp. 71-78
Author(s):  
R. M. Sharifulin ◽  
A. V. Bogachev-Prokophiev ◽  
I. I. Demin ◽  
A. B. Open ◽  
M. A. Ovcharov ◽  
...  
Keyword(s):  
Right Ventricular ◽  
Group Versus ◽  
Right Ventricular Outflow Tract ◽  
Study Groups ◽  
Ventricular Outflow Tract ◽  
Outflow Tract ◽  
Pressure Gradients ◽  
Ross Procedure ◽  
The Right

Aim The aim of this study was to compare the results of right ventricular outflow tract reconstruction during the Ross procedure with pulmonary allografts versus diepoxide-treated pericardial xenografts. Methods Between 1998 and 2015, 793 adult patients underwent the Ross procedure. The right ventricular outflow tract reconstruction was performed with pulmonary allografts in 185 patients, diepoxide-treated pericardial xenografts in 402 patients. Two groups of patients (122 patients in each group) were allocated using «propensity score matching»: the allograft group (pulmonary allograft) and the xenograft group (xenograft). Surgical results in two groups were assessed. Results The overall early mortality rate in both groups was 2.5%. The mean follow-up was 5,1±2,6 years in the allograft group and 5,2±2,8 years in xenograft group (p = 0,692). The 5-year survival rate did not differ between the study groups (93,7±2,6% in the allograft group versus 94,02±2,4% in the xenograft group, p = 0.748). The peak pressure gradients across the right ventricular outflow tract in early and mid-term follow-up were significantly higher in the xenograft group. Two patients in the xenograft group underwent redo surgeries due to the graft failure. There were no reoperations in the allograft group (p = 0,176). The freedom from right ventricular outflow tract reoperations was 96,3±2,7% for the xenograft group. Conclusion The diepoxide-treated pericardial xenografts demonstrates acceptable haemodynamic results at the mid-term follow-up and could be considered as an alternative to allografts for right ventricular outflow tract reconstruction during the Ross procedure in adults. Further study focused on the assessment of the longterm results are required.

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