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 Long-term results of large-calibre expanded polytetrafluoroethylene-valved conduits with bulging sinuses

2020 ◽  
Vol 58 (6) ◽  
pp. 1274-1280
Author(s):  
Shuhei Fujita ◽  
Masaaki Yamagishi ◽  
Takako Miyazaki ◽  
Yoshinobu Maeda ◽  
Keiichi Itatani ◽  
...  
Keyword(s):  
Right Ventricular ◽  
Right Ventricular Outflow Tract ◽  
Ventricular Outflow Tract ◽  
Outflow Tract ◽  
The Body ◽  
Long Term Results ◽  
Pulmonary Insufficiency ◽  
Long Term Outcomes ◽  
Expanded Polytetrafluoroethylene

Abstract OBJECTIVES In Japan, homograft and bovine jugular vein are available in very limited institutions for the reconstruction of the right ventricular outflow tract, and handmade expanded polytetrafluoroethylene (ePTFE)-valved conduits have been widely used instead. This study aimed to clarify the long-term outcomes and the durability of the ePTFE-valved conduits purely by narrowing down to those with large sizes to eliminate the influence of the body growth. METHODS Between January 2002 and December 2015, patients who underwent right ventricular outflow tract reconstruction in 34 Japanese institutions using ePTFE-valved conduits with a diameter of ≥18 mm were included. All the valved conduits were made in the authors’ institution and delivered to each participating institution. RESULTS Overall, 502 patients were included. Early mortality was 1.4% and not related to conduit failure. The overall survival rate was 98.2% at 5 years and 96.6% at 10 years. Freedom from conduit explantation was 99.5% at 5 years and 89.0% at 10 years. Three patients (0.13 per 100 patient-years) developed infective endocarditis of the conduit, and only 1 patient required conduit removal. Pulmonary insufficiency was mild or less in 480 (96%) patients, and conduit stenosis was mild or less in 436 (88%) patients at the latest follow-up. CONCLUSIONS By narrowing the analyses down to only ePTFE conduits with a large size, satisfactory long-term outcomes of these conduits with a fan-shaped valve and bulging sinuses were shown. These conduits would be among the optimal choices for right ventricular outflow tract reconstruction.

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

Long-term results of right ventricular outflow tract reconstruction with Contegra®

2021 ◽  
Vol 13 (4) ◽  
pp. 301
Author(s):  
Camille Guidon ◽  
Paul Neville ◽  
Nathalie Soulé ◽  
Jacques Poinsot ◽  
Jean Marc El Arid ◽  
...  
Keyword(s):  
Right Ventricular ◽  
Right Ventricular Outflow Tract ◽  
Ventricular Outflow Tract ◽  
Outflow Tract ◽  
Long Term Results

Reconstruction of the Right Ventricular Outflow Tract With a Conduit in Congenital Heart Disease

PEDIATRICS ◽  
1977 ◽  
Vol 60 (3) ◽  
pp. 313-319
Author(s):  
John A. Waldhausen ◽  
William S. Pierce ◽  
Victor Whitman ◽  
John L. Pennock
Keyword(s):  
Congenital Heart Disease ◽  
Right Ventricular ◽  
Congenital Heart ◽  
Right Ventricular Outflow Tract ◽  
Ventricular Outflow Tract ◽  
Outflow Tract ◽  
Long Term Results ◽  
Surgical Reconstruction ◽  
The Right

A series of five patients with complex cyanotic congenital cardiac malformations underwent surgical reconstruction of the right ventricular outflow tract using a Dacron conduit with a porcine aortic valve. All patients survived and all have shown clinical improvement. At cardiac catheterization postoperatively, a pressure gradient of between 20 and 50 mm Hg across the conduit was found in all patients. This surgical approach to patients necessitating reconstruction of the right ventricular outflow tract is effective and appears to have the best long-term results.

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