Decennial follow-up in patients with recurrent tachycardia originating from the right ventricular outflow tract: electrophysiologic characteristics and response to treatment

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.

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A five year follow-up of aortic homograft monocusps used in reconstruction of the right ventricular outflow tract in infants with tetralogy of fallot

The American Journal of Cardiology ◽

10.1016/0002-9149(81)90938-3 ◽

1981 ◽

Vol 47 ◽

pp. 466

Author(s):

Rosemary Radley-Smith ◽

Charles Ilsley ◽

Colin Reid ◽

Magdi Yacoub

Keyword(s):

Right Ventricular ◽

Tetralogy Of Fallot ◽

Right Ventricular Outflow Tract ◽

Ventricular Outflow Tract ◽

Outflow Tract ◽

Aortic Homograft ◽

The Right

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The morphology of the right ventricular outflow tract after percutaneous pulmonary valvotomy: long term follow up.

Heart ◽

10.1136/hrt.58.3.239 ◽

1987 ◽

Vol 58 (3) ◽

pp. 239-244 ◽

Cited By ~ 32

Author(s):

M Robertson ◽

L N Benson ◽

J S Smallhorn ◽

N Musewe ◽

R M Freedom ◽

...

Keyword(s):

Right Ventricular ◽

Right Ventricular Outflow Tract ◽

Ventricular Outflow Tract ◽

Outflow Tract ◽

Long Term Follow Up ◽

The Right

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Mid-term outcomes of Contegra implantation for the reconstruction of the right ventricular outflow tract to proximal branch pulmonary arteries: Japan multicentre study

Interactive Cardiovascular and Thoracic Surgery ◽

10.1093/icvts/ivab075 ◽

2021 ◽

Author(s):

Takaya Hoashi ◽

Hajime Ichikawa ◽

Keiichi Hirose ◽

Naohiro Horio ◽

Takahisa Sakurai ◽

...

Keyword(s):

Risk Factor ◽

Right Ventricular ◽

Survival Rates ◽

Pulmonary Arteries ◽

Right Ventricular Outflow Tract ◽

Ventricular Outflow Tract ◽

Outflow Tract ◽

Free Survival ◽

The Right

Abstract OBJECTIVES To reveal the mid-term outcomes of Contegra implantation for the reconstruction of the right ventricular outflow tract to proximal branch pulmonary arteries in a multicentre study. METHODS Between April 2013 and December 2019, 178 Contegra conduits were implanted at 5 Japanese institutes. The median age and body weight at operation were 16 months (25th–75th percentile: 8–32) and 8.3 kg (6.4–10.6). Sixteen patients were neonates (9.0%). Selected conduit sizes were 12 mm in 28 patients (15.7%), 14 mm in 67 patients (37.6%), 16 mm in 66 patients (37.1%), 18 mm in 5 patients (2.8%) and <12 mm in 12 patients (6.7%). Fifty-six grafts (31.4%) were ring supported. Proximal branch pulmonary arteries were concomitantly augmented in 85 patients (47.5%). Follow-up was completed in all patients and the median follow-up period was 3.1 years (1.3–5.1). RESULTS The overall, conduit explantation-free and conduit infection-free survival rates at 5 years were 91.3%, 71.0% and 83.7%, respectively. Infection (P = 0.009) and common arterial trunk (P = 0.024) were risk factors for explantation. Conduit durability was shorter in smaller one (P < 0.001). Catheter interventions (for conduit to proximal branch pulmonary artery)-free survival rates at 5 years was 52.9%; however, need for catheter interventions was not a risk factor for conduit explantation. CONCLUSIONS Mid-term outcomes of reconstruction of the right ventricular outflow tract to the proximal branch pulmonary arteries with Contegra were acceptable. The need for explantation over time was higher in smaller conduits. Conduit infection was a strong risk factor for conduit explantation. Frequently and repeated catheter interventions effectively extended the conduit durability.

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

Complex Issues of Cardiovascular Diseases ◽

10.17802/2306-1278-2018-7-2-71-78 ◽

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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Implantation and Follow-Up of ICD Leads Implanted in the Right Ventricular Outflow Tract

Pacing and Clinical Electrophysiology ◽

10.1111/j.1540-8159.2000.tb07071.x ◽

2000 ◽

Vol 23 (11P2) ◽

pp. 1996-1998 ◽

Cited By ~ 10

Author(s):

ANDRZEJ LUBINSKI ◽

EWA LEWICKA-NOWAK ◽

TOMASZ KRÓLAK ◽

MACIEJ KEMPA ◽

BEATA BIELAWSKA ◽

...

Keyword(s):

Right Ventricular ◽

Right Ventricular Outflow Tract ◽

Ventricular Outflow Tract ◽

Outflow Tract ◽

Icd Leads ◽

The Right

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Use of Oversized Injectable Valves in Growing Children for Total Repair of Right Ventricular Outflow Tract Anomalies (Preliminary Results)

Texas Heart Institute Journal ◽

10.14503/thij-13-3359 ◽

2014 ◽

Vol 41 (4) ◽

pp. 373-380 ◽

Cited By ~ 5

Author(s):

Luca Deorsola ◽

Pietro Angelo Abbruzzese

Keyword(s):

Right Ventricular ◽

Pulmonary Regurgitation ◽

Right Ventricular Outflow Tract ◽

Ventricular Outflow Tract ◽

Outflow Tract ◽

Expansion Process ◽

Preliminary Results ◽

Original Size ◽

The Right

Right ventricular outflow tract surgery was originally confined to transannular patching, in the belief that pulmonary regurgitation was well tolerated. Because follow-up evaluations revealed the deleterious effects of pulmonary regurgitation, surgery today aims to spare or replace the valve. Available replacement devices have short lifetimes, considering growth mismatch in children. We hypothesize that oversizing the right infundibulum anticipates growth and that a squeezed prosthesis can complete the expansion process. The No-React® Injectable BioPulmonic Valve is designed for right infundibular surgery in adults, and hundreds of implants have shown promising results. We used this device for surgery in babies, with the addition of an innovative oversizing technique. This study evaluates our preliminary results and investigates whether such a technique might reduce growth mismatch. From September 2010 through July 2012, we implanted 11 injectable pulmonic valves. The median age of our patients was 23 months. After opening the right infundibulum, we enlarged it as much as possible with a wide patch. Before completing the patch suture, we injected an oversized valve. No problems occurred during surgery. No major insufficiency or leak was observed. We conclude that prostheses can be quite oversized and perform well even when not completely expanded. Oversized injectable pulmonic valves, shrunken to a smaller diameter, enabled the implantation of a device wider than otherwise possible, without affecting performance. Moreover, the prosthesis tended to return to its original size following growth, thereby reducing growth mismatch. Longer follow-up and larger numbers of patients are needed for verification.

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