scholarly journals Results of large pulmonary homograft implantation for right ventricular outflow tract reconstruction

2020 ◽  
Author(s):  
Simon Dang Van ◽  
Carine Pavy ◽  
Guillaume Guimbretière ◽  
Julie Boulanger ◽  
Pierre Maminirina ◽  
...  
Keyword(s):  
Right Ventricular ◽  
Right Ventricular Outflow Tract ◽  
Ventricular Outflow Tract ◽  
Outflow Tract ◽  
Pulmonary Homograft

Contegra versus pulmonary homograft for right ventricular outflow tract reconstruction in newborns

2019 ◽  
Vol 29 (4) ◽  
pp. 505-510 ◽  
Author(s):  
Alessandro Falchetti ◽  
Hélène Demanet ◽  
Hugues Dessy ◽  
Christian Melot ◽  
Charalampos Pierrakos ◽  
...  
Keyword(s):  
Right Ventricular ◽  
Heart Surgery ◽  
Multivariable Analysis ◽  
Right Ventricular Outflow Tract ◽  
Ventricular Outflow Tract ◽  
Congenital Heart Surgery ◽  
Outflow Tract ◽  
Conflicting Evidence ◽  
Pulmonary Homograft

AbstractObjectives:Pulmonary homografts are standard alternatives to right ventricular outflow tract reconstruction in congenital heart surgery. Unfortunately, shortage and conduit failure by early calcifications and shrinking are observed for small-sized homografts in younger patients. In neonates, Contegra® 12 mm (Medtronic Inc., Minneapolis, Minnesota, United States of America) could be a valuable alternative, but conflicting evidence exists. There is no published study considering only newborns with heterogeneous pathologies. We retrospectively compared the outcomes of these two conduits in this challenging population.Methods:Patients who underwent a right ventricular outflow tract reconstruction between January 1992 and December 2014 at the Hôpital Universitaire des Enfants Reine Fabiola were included. We retrospectively collected and analysed demographic, echocardiographic, surgical, and follow-up data.Results:Of the 53 newborns who benefited from a right ventricular outflow tract reconstruction during the considered period, 30 received a Contegra 12 mm (mean age 15 ± 8 days), and 23 a small (9–14 mm) pulmonary homograft (mean age 10 ± 7 days). Overall mortality was 16.6% with Contegra versus 17.4% in the pulmonary homograft group (p = 0.98 log-rank). Operative morbidity and early re-operation for conduit failure were not significantly different between the two groups. Mean follow-up in this study is 121 ± 74 months. Survival free from re-operation was not different between the two groups (p = 0.15). Multivariable analysis showed that weight and significant early gradient were factors associated with anticipated conduit failure.Conclusions:Contegra 12 mm is a valid alternative to small pulmonary homografts in a newborn patient population. Trial registration: NCT03348397.

scholarly journals Results of large pulmonary homograft implantation for right ventricular outflow tract reconstruction

2020 ◽  
Author(s):  
Simon DANG VAN ◽  
Carine Pavy ◽  
Guillaume Guimbreti re ◽  
Julie Boulanger ◽  
Pierre Maminirina ◽  
...  
Keyword(s):  
Right Ventricular ◽  
Right Ventricular Outflow Tract ◽  
Ventricular Outflow Tract ◽  
Outflow Tract ◽  
Pulmonary Homograft

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.

Mechanism of transcatheter heart valve deployment for right ventricular outflow tract insufficiency after surgical reconstruction in childhood as assessed with intravascular ultrasound

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
L Kalinczuk ◽  
K Rynkiewicz ◽  
W Skotarczak ◽  
G.S Mintz ◽  
K Zielinski ◽  
...  
Keyword(s):  
Right Ventricular ◽  
Intravascular Ultrasound ◽  
Heart Valve ◽  
Cross Sections ◽  
Right Ventricular Outflow Tract ◽  
Ventricular Outflow Tract ◽  
Outflow Tract ◽  
Lumen Diameter ◽  
Transcatheter Heart Valve ◽  
Pulmonary Homograft

Abstract Introduction Transcatheter heart valve (THV) deployment can be used to treat right ventricular outflow tract (RVOT) insufficiency. Purpose To study deployment mechanism of a balloon expandable THV (Melody or Edwards SAPIEN [ES] 3) implanted for pulmonary homograft insufficiency using intravascular ultrasound (IVUS) with Visions PV.035 Digital Catheter (Philips) offering an imaging field of 60mm. Methods Sequential (baseline and post-THV) IVUS was performed in 6 pts (median age 33 [20–44] yrs, 3 ♀, all with Tetralogy of Fallot) who had undergone prior corrective surgery (4 transannular patch, 1 bioprosthetic valve or 1 pulmonary homograft), but who presented with significant RVOT insufficiency. IVUS-visualized homograft cross-sections were perpendicular to its long axis and were obtained along the entire homograft length (Fig. 1). Volumetric measurements included the native pulmonary homograft (inner lumen and outer dimension) and the corresponding inner-stent/inner-THV cross-sections post-THV for a total of 16 evenly spaced cross-sections per analyzed region. Each THV (1 Melody [Ø 22mm, 28mm nominal length] and 5 ES3 [Ø 23mm, 18mm height; 4 Ø 29mm, 22.5mm height]) was implanted after pre-stenting using stents of 36, 39, or 48mm length, deployed on a 24mm (n=1) or 30mm (n=4) balloon-in-balloon catheter. Results Overall, there were 96 paired cross-sections. There was significant increase in average lumen dimension after THV deployment (Δ of 97.5mm2) accompanied by the similar increase in outer pulmonary homograft dimensions (Δ of 84.0mm2) (Table 1). Whereas the maximal lumen diameter was unchanged, the minimal lumen diameter increased significantly resulting in substantial decrease in the ratio of max/min lumen diameter of 1.41±0.20 vs 1.16±0.13 (p<0.001) representing a reduction in lumen eccentricity. Conclusions During balloon-expandable THV implantation to treat RVOT insufficiency, there is a significant increase in baseline lumen dimensions accompanied by a substantial outer RVOT dimension increase to normalize lumen eccentricity. Figure 1. IVUS intraprocedural visualisation Funding Acknowledgement Type of funding source: None

Pulmonary Homograft Monocusp Reconstruction of the Right Ventricular Outflow Tract: Outcomes to the Intermediate Term

2010 ◽  
Vol 90 (1) ◽  
pp. 42-49 ◽  
Author(s):  
Dilip S. Nath ◽  
Daniel P. Nussbaum ◽  
Christopher Yurko ◽  
Omar M. Ragab ◽  
Angela J. Shin ◽  
...  
Keyword(s):  
Right Ventricular ◽  
Right Ventricular Outflow Tract ◽  
Ventricular Outflow Tract ◽  
Outflow Tract ◽  
The Right ◽  
Pulmonary Homograft
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