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The Journal of Cardiovascular Surgery 2001 February;42(1):17-21

Copyright © 2009 EDIZIONI MINERVA MEDICA

language: English

Homologous monocuspid valve patch in right ventricular outflow tract reconstruction

Jun T. G., Park P. W., Park K. H., Chae H., Kang I. S., Lee H. J.

From the Department of Thoracic and Cardiovascular Surgery *Department of Pediatric Cardiology Samsung Seoul Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea


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Background. In the sur­gi­cal ­repair of tet­ral­o­gy of Fallot or pul­mo­nary atre­sia, pul­mo­nary regur­gi­ta­tion may be det­ri­men­tal in the post­op­er­a­tive peri­od. We ­have ­used homo­graft mono­cus­pid ­valve ­patch to pre­vent pul­mo­nary insuf­fi­cien­cy.
Methods. From September 1996 to December 1998, twen­ty-­five ­patients, 4 ­months to 8 ­years of age (­median 10.1 ­months) had homo­graft mono­cus­pid ­valve in the pro­ce­dure of ­right ven­tric­u­lar out­flow ­tract recon­struc­tion. The func­tion of the mono­cus­pid ­valve was ­assessed by ech­o­car­di­o­gram and grad­ed as triv­i­al to ­mild, ­mild to mod­er­ate, mod­er­ate, and ­severe. We eval­u­at­ed the ­degree of pul­mo­nary insuf­fi­cien­cy ­before dis­charge, at 3-6 ­months, and at 12 ­months ­after the oper­a­tion.
Results. There was one hos­pi­tal ­death due to ful­mi­nate ade­no ­viral pneu­mo­nia. On ech­o­car­di­o­gram, 21 ­patients (88%, 21/24) had no sig­nif­i­cant pul­mo­nary insuf­fi­cien­cy. Only one ­patient (4.5%) ­showed a mod­er­ate ­degree of pul­mo­nary insuf­fi­cien­cy. At 3-6 ­months, sev­en­teen of twen­ty-one (81%) ­patients had no sig­nif­i­cant pul­mo­nary insuf­fi­cien­cy. There ­were four­teen ­patients who had fol­low-up ­over 1 ­year, and no ­patients ­showed new­ly devel­oped sig­nif­i­cant pul­mo­nary insuf­fi­cien­cy.
Conclusions. We con­clud­ed ­that the homo­graft mono­cus­pid ­valve ­patch for ­right ven­tric­u­lar out­flow ­tract recon­struc­tion has pro­vid­ed excel­lent ear­ly ­results for the pre­ven­tion of pul­mo­nary insuf­fi­cien­cy. However ­these ­effects are lim­it­ed in dura­tion and fur­ther ­close fol­low-up ­should be need­ed.

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