S. Sharma et al., CLINICAL-RESULTS OF CRYOPRESERVED VALVED CONDUITS IN THE PULMONARY VENTRICLE-TO-PULMONARY ARTERY POSITION, The American journal of surgery, 165(5), 1993, pp. 587-591
Aortic valved homograft conduits (AVHC) have become valuable in the pu
lmonary ventricle (PV)-to-main pulmonary artery (MPA) reconstruction i
n congenital heart defects. Since 1985, 45 patients, ranging in age fr
om 12 days to 32 years, underwent PV-to-MPA reconstruction utilizing c
ryopreserved AVHC. Operative deaths included seven patients (16%), six
of whom died as a result of the complexity of their underlying heart
defects. One late death (2%) occurred as a result of infective endocar
ditis 48 months after conduit placement. The 38 patients who survived
the operation remained in the intensive care unit for a mean of 5.7 +/
- 1.0 days (median: 4 days; range: 2 to 37 days). The mean hospital st
ay was 13.0 +/- 1.8 days (median: 9 days; range: 6 to 63 days). The me
an follow-up was 40.0 +/- 3.6 months (median: 40 months; range: 10 mon
ths to 7.1 years).Only two patients (5%) required reoperation for cond
uit stenosis with systolic pressure gradients of 60 to 80 mm Hg at 10
and 14 months, respectively, after operation, and both reoperations we
re successful. During outpatient visits, 16 patients are totally asymp
tomatic, and 21 patients have minimal symptoms (New York Heart Associa
tion class II). Only 10 patients (26%) require digoxin, and 2 patients
(5%) need diuretics as part of their medical regimen. Recent echocard
iographic examinations show insignificant pressure gradients in all 37
currently surviving patients. Thus, barring operative mortality, whic
h is almost always associated with the nature of the underlying heart
defect, the use of cryopreserved AVHC is a safe and effective alternat
ive for PV-to-MPA reconstruction.