TY - JOUR
T1 - Surgical connections from ventricle to pulmonary artery
T2 - Comparison of four types of valved implants
AU - Razzouk, A. J.
AU - Williams, W. G.
AU - Cleveland, D. C.
AU - Coles, J. G.
AU - Rebeyka, I. M.
AU - Trusler, G. A.
AU - Freedom, R. M.
N1 - Your access to the NCBI website at www.ncbi.nlm.nih.gov has been temporarily blocked due to a possible misuse/abuse situation involving your site. This is not an indication of a security issue such as a virus or attack.
PY - 1992/11
Y1 - 1992/11
N2 - Background. Four types of valved conduits used to correct venous ventricle to pulmonary artery (V-PA) discontinuity were compared. Methods and Results. Four hundred fifty-seven patients with congenital heart defects requiring a V-PA connection during the past 25 years were reviewed. Age at implant varied from 1 day to 64 years (mean, 9.1 years). Four types of valved prostheses were used: 1) homograft conduit (HC, n=178), 2) valved Dacron conduit (VDC, n=126), 3) polystan conduit (PC, n=47), and 4) orthotopic pulmonary valve implant (PVI, n=106). There were 83 early deaths (18.2%) and 34 late deaths (8.5%). Follow-up ranged from 1 month to 22 years (mean, 3.5 years). One hundred eight conduit replacements were performed in 93 patients (21%). The overall patient survival was 73±2.3%, 67±3.2%, and 56±6.8% at 5, 10, and 15 years, respectively. Factors predictive of patient survival were diagnosis (p<0.001) and valve size (p<0.001). Age at operation (p<0.001) and type of valve (p<0.001) were the only risk factors for valve survival. At 5 years, survival of PVI (89±5%) and VDC (89±4%) was significantly better than survival of HC (46±13%) or PC (57±9%). Conclusions. Patients who survived the initial construction of a V-PA conduit had a reasonable long-term survival. A PVI was the most durable prosthesis. A Dacron porcine-valved conduit had significantly better durability than either a cryopreserved homograft or a PC.
AB - Background. Four types of valved conduits used to correct venous ventricle to pulmonary artery (V-PA) discontinuity were compared. Methods and Results. Four hundred fifty-seven patients with congenital heart defects requiring a V-PA connection during the past 25 years were reviewed. Age at implant varied from 1 day to 64 years (mean, 9.1 years). Four types of valved prostheses were used: 1) homograft conduit (HC, n=178), 2) valved Dacron conduit (VDC, n=126), 3) polystan conduit (PC, n=47), and 4) orthotopic pulmonary valve implant (PVI, n=106). There were 83 early deaths (18.2%) and 34 late deaths (8.5%). Follow-up ranged from 1 month to 22 years (mean, 3.5 years). One hundred eight conduit replacements were performed in 93 patients (21%). The overall patient survival was 73±2.3%, 67±3.2%, and 56±6.8% at 5, 10, and 15 years, respectively. Factors predictive of patient survival were diagnosis (p<0.001) and valve size (p<0.001). Age at operation (p<0.001) and type of valve (p<0.001) were the only risk factors for valve survival. At 5 years, survival of PVI (89±5%) and VDC (89±4%) was significantly better than survival of HC (46±13%) or PC (57±9%). Conclusions. Patients who survived the initial construction of a V-PA conduit had a reasonable long-term survival. A PVI was the most durable prosthesis. A Dacron porcine-valved conduit had significantly better durability than either a cryopreserved homograft or a PC.
KW - Bioprosthesis
KW - Conduit
KW - Homograft
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M3 - Article
C2 - 1423993
SN - 0009-7322
VL - 86
SP - II154-II158
JO - Circulation
JF - Circulation
IS - 5 SUPPL.
ER -