Fate of the autologous tri-cusp-valved pericardial conduit in the right ventricular outflow tract of growing pigs.
No perfect valve or valved conduit is currently available to reconstruct the right ventricular outflow tract (RVOT) in pediatric patients. To investigate the fate of autologous pericardial valved conduit, twenty piglets weighing 12.2 +/- 1.4 kg were divided into two groups. In 10 of them, the pericardium was immersed in 0.6% glutaraldehyde for 5 minutes (Gr PG) and then washed with normal saline. In the other 10 pigs, the pericardium was immersed in normal saline only (Gr PN) after procurement. Afterwards the autologous pericardium was tailored as designed to build a tri-cusp-valve inside the pericardial conduit with reconstruction of the sinus of Valsalva. This conduit was connected to the pulmonary trunk (PT) distally and RVOT proximally without a pump. The PT was then doubly ligated just above the annulus. The pigs survived 114 +/- 92 days in Gr PG and 82 +/- 50 days in Gr PN. The body weight increased to 42 +/- 29 kg in Gr PG and 30 +/- 9 kg in Gr PN. No cusps adhered to the conduit wall in either group. In Gr PN, the valve became retracted; in 7 of them an aneurysm developed proximal to the stenotic pulmonary valve, while only one pig in Gr PG developed an aneurysm. In Gr PG, the leaflet and conduit showed evidence of growth. In contrast, no evidence of valve growth was found in Gr PN. Calcification was evident more in Gr PG than in Gr PN either on the leaflet (9/10 vs. 5/10) or in the wall of conduit (8/10 vs. 6/10), but the differences were not statistically significant.(ABSTRACT TRUNCATED AT 250 WORDS)
Chiu
I S
IS
Department of Surgery, National Taiwan University Hospital, Taipei, Republic of China.
How
S W
SW
Hou
S H
SH
Wang
E
E
D000818:Animals; D001705:Bioprosthesis; D006350:Heart Valve Prosthesis; D006352:Heart Ventricles / Q000601:surgery; D010496:Pericardium / Q000601:surgery; D011664:Pulmonary Valve / Q000033:anatomy & histology / Q000601:surgery; D012850:Sinus of Valsalva / Q000601:surgery; D013552:Swine; D016276:Ventricular Function