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FASCICOLI E ARTICOLI   I PIÙ LETTI   eTOC

ULTIMO FASCICOLOTHE JOURNAL OF CARDIOVASCULAR SURGERY

Rivista di Chirurgia Cardiaca, Vascolare e Toracica

Indexed/Abstracted in: BIOSIS Previews, Current Contents/Clinical Medicine, EMBASE, PubMed/MEDLINE, Science Citation Index Expanded (SciSearch), Scopus
Impact Factor 1,632

Periodicità: Bimestrale

ISSN 0021-9509

Online ISSN 1827-191X

 

The Journal of Cardiovascular Surgery 2002 Dicembre;43(6):779-86

CARDIAC SECTION 

 ORIGINAL ARTICLES

Fan-shaped expanded polytetrafluoroethylene valve in the pulmonary position

Yamagishi M. 1, Kurosawa H. 2, Nomura K. 2, Kitamura N. 2

1 Department of Pediatric Cardiovascular Surgery Children’s Research Hospital, Kyoto Prefectural University of Medicine, Kyoto, Japan
2 Department of Cardiovascular Surgery Jikei University School of Medicine, Tokyo, Japan

Background. Residual pul­mo­nary insuf­fi­cien­cy ­remains a prob­lem ­after trans­an­nu­lar ­repair in pedi­at­ric ­patients. We ­have devel­oped fan-­shaped mono­cus­pid and bicus­pid ­valves ­made of expand­ed poly­tet­ra­flu­o­roe­thy­lene (ePTFE) mem­brane for ­repair of ­right ven­tric­u­lar out­flow ­tract obstruc­tion in ­patients ­with tet­ral­o­gy of Fallot.
Methods. We stud­ied 20 ­patients (­mean age, 39.6 ­months) ­with tet­ral­o­gy of Fallot. The ­right ven­tric­u­lar out­flow ­tract was recon­struct­ed ­with use of a ­short, ­wide trans­an­nu­lar ­patch and a fan-­shaped ­valve ­made of 0.1-mm-­thick expand­ed ePTFE mem­brane (PRE­CLUDE Pericardial Membrane, W.L. Gore & Associates, Inc, Flagstaff, AZ). The ­width of the ­valve and the out­flow ­patch ­were con­struct­ed so ­that the neo­pul­mo­nary annu­lus was approx­i­mate­ly 130% the nor­mal ­size.
Results. A mono­cus­pid ­valve was ­used in 17 ­patients and a bicus­pid ­valve in 3. The ­mean fol­low-up ­time was 32.3 ­months (­range, 14.7 to 56.7 ­months). Right ven­tric­u­lar func­tion was ­well main­tained in all ­patients. Valvular ­motion ­remained com­pe­tent in 13 ­patients (65%). In the remain­ing 7 (35%), the ­valve ­became ­fixed in the ­open posi­tion. Trivial and ­mild pul­mo­nary insuf­fi­cien­cy was detect­ed in 10 ­patients ­with a com­pe­tent ­valve and 7 ­with an incom­pe­tent ­valve. No pres­sure gra­di­ent ­across the neo­pul­mo­nary annu­lus or cal­cifi­ca­tion of the expand­ed ePTFE mem­brane was detect­ed in any ­patient.
Conclusions. The fan-­shaped expand­ed ePTFE ­valve is a use­ful sub­sti­tute ­with ade­quate func­tion in trans­an­nu­lar ­right ven­tric­u­lar out­flow recon­struc­tion.

lingua: Inglese


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