Right ventricular outflow tract reconstruction with the bovine jugular vein graft: 5 years' experience with 133 patients

Détails

ID Serval
serval:BIB_0993E6E154F1
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Institution
Titre
Right ventricular outflow tract reconstruction with the bovine jugular vein graft: 5 years' experience with 133 patients
Périodique
Annals of Thoracic Surgery
Auteur(s)
Sekarski  N., van Meir  H., Rijlaarsdam  M. E., Schoof  P. H., Koolbergen  D. R., Hruda  J., von Segesser  L. K., Meijboom  E. J., Hazekamp  M. G.
ISSN
1552-6259
Statut éditorial
Publié
Date de publication
08/2007
Peer-reviewed
Oui
Volume
84
Numéro
2
Pages
599-605
Notes
Journal Article --- Old month value: Aug
Résumé
BACKGROUND: We analyzed the results in two centers of using bovine jugular vein graft for right ventricular outflow tract reconstruction. METHODS: From April 1999 to July 2005, 133 children with a median age of 30.9 months (range, 4 days to 19 years) underwent graft implantation. Echocardiography was performed during follow-up and retrospectively reviewed. RESULTS: Nongraft-related early mortality occurred in 8 patients. Late mortality occurred in 11 patients, 2 late deaths were graft related (endocarditis). Median follow-up was 31.6 months (range, 1 to 73). Twelve patients received a new graft, because of endocarditis (3), distal pulmonary artery branch stenosis (4), graft obstruction caused by fibrosis (4), or thrombosis (1). Echocardiography Doppler studies showed good conduit function, with 92% of the patients having absent, trivial, or only mild valve regurgitation at last follow-up. A moderate degree of conduit stenosis due to external compression was observed in 2 patients. Twenty-five patients with otherwise intact conduits had hemodynamically significant distal stenosis. In most cases, the pulmonary branch stenosis was related to preoperative small pulmonary arteries and young age at operation. At 31.6 months, significant graft dilatation was observed in 4 grafts and was related to pulmonary artery branch obstruction or pulmonary hypertension. Calcification did not occur in 5 years time. Survival was 85.7%, freedom from conduit explantation was 91%, and freedom from intervention for pulmonary artery branch stenosis was 80% after 5 years. CONCLUSIONS: The bovine jugular vein graft is a valuable right ventricular outflow tract conduit, but younger age and small pulmonary arteries increase the risk of distal conduit stenosis.
Mots-clé
Adolescent Animals Cattle Child Child, Preschool Echocardiography Heart Ventricles/*surgery/ultrasonography Humans Infant Infant, Newborn Jugular Veins/*transplantation Pulmonary Atresia/*surgery Reconstructive Surgical Procedures Retrospective Studies Survival Analysis Transplantation, Heterologous/mortality Treatment Outcome Truncus Arteriosus/*surgery Ventricular Dysfunction, Right
Pubmed
Web of science
Création de la notice
14/02/2008 14:17
Dernière modification de la notice
20/08/2019 12:31
Données d'usage