[An extracardiac valved graft in the establishment of continuity between the right ventricle and the pulmonary arteries. The technics and the results of their use in correcting common truncus arteriosus].
OBJECTIVE
To evaluate the results of valved extracardiac conduits for establishment of right ventricle pulmonary artery continuity in patients with truncus arteriosus communis.


METHODS
between January 1981-January 1991, 15 patients with persistent truncus arteriosus communis underwent surgical repair with valved extracardiac conduits for establishment of right ventricle-pulmonary artery continuity. Mean age was 2 years 9 months and mean weight 9.6 kg. Eight patients were females and seven males. The diagnosis was established by hemodynamics and/or echocardiographic studies and surgical indication was based in presence of cardiac insufficiency and prevention of pulmonary vascular disease. Valved conduits were performed with insertion of pericardial xenograft in woven dacron prosthesis. Diameters ranged between 12 to 22 mm.


RESULTS
The in-hospital mortality was 33% and the low output syndrome was the main cause. Post-operative complications, with variable gravity, occurred in 80% of the patients. Reoperation occurred in four patients during the long term follow-up due to stenotic complications of the valved conduit, mean 5 years 2 months after implant. Late mortality was 30%, with correspondent actuarial life table of 66.6% in 1st year, 53.3%, 3rd and 46.2% in 5 and 10 years.


CONCLUSIONS
Although the valved extracardiac conduits have significantly improved the survival of patients with truncus arteriosus communis, late stenotic complications were high determining continuous development of direct ventricle-arterial anastomosis techniques.
Baucia
J A
JA
Hospital Sírio-Libanês, Hospital Matarazzo e Beneficência Portuguesa de São Paulo.
D001705:Bioprosthesis; D001807:Blood Vessel Prosthesis; D002648:Child; D002675:Child, Preschool; D005069:Evaluation Studies as Topic; D005260:Female; D005500:Follow-Up Studies; D006352:Heart Ventricles / Q000601:surgery; D006801:Humans; D007223:Infant; D008297:Male; D011093:Polyethylene Terephthalates; D011183:Postoperative Complications / Q000453:epidemiology; D011474:Prosthesis Design; D011651:Pulmonary Artery / Q000601:surgery*; D013526:Surgical Mesh; D014339:Truncus Arteriosus, Persistent / Q000150:complications / Q000601:surgery*
D011093:Polyethylene Terephthalates
Enxerto valvulado extracardíaco no estabelecimento da continuidade entre o ventrículo direito e as artérias pulmonares. Técnicas e resultados de sua aplicação na correção do tronco arterioso comum.