Imaging analysis of platelet deposition on the extracardiac valved conduit in humans.
In 14 patients (aged 2-29 yr) with Hancock (n = 11) or Carpentier-Edwards extracardiac valved conduits (n = 3), platelet deposition (PD) was investigated using indium 111 (111In) platelet imaging. Repeated studies were performed in five patients. By visual analysis, 71% (5/7) of the imagings (7 images/5 patients) showed PD at early study 1-3 months after surgery, 9% (1/11) at intermediate study at 6-46 months (mean 21 mon) (11 images/10 patients) and 0% at late study at 81-132 months (3 images/3 patients). Quantitative analysis was made using relative ratio of radioactivity at the graft area to the area of the brachiocephalic artery (platelet accumulation index or PAI). The PAI was 1.85 +/- 0.47 (mean +/- SD) at early study, 1.51 +/- 0.23 at intermediate, and 1.36 +/- 0.37 at late study (NS). There was no significant difference in the late pressure gradients across the conduit (16-68 mon postoperatively) between the two groups with (n = 3) and without (n = 5) PD at the early stage (1-18 mon postoperatively, n = 8). The result may indicate that PD to the valved conduit in the right ventricular (RV) outflow tract occurs early postoperatively (mostly within 3 mon). The relationship of the PD detected by this method to late obstruction was not clarified in this study.
Kawata
H
H
First Department of Surgery, Osaka University Medical School, Japan.
Matsuda
H
H
Isaka
Y
Y
Kaneko
M
M
Matsuwaka
R
R
Kobayashi
J
J
Matsuki
O
O
Nakano
S
S
Kimura
K
K
Kawashima
Y
Y
D000293:Adolescent; D000328:Adult; D001705:Bioprosthesis; D001807:Blood Vessel Prosthesis; D002648:Child; D002675:Child, Preschool; D005500:Follow-Up Studies; D006083:Graft Occlusion, Vascular / Q000097:blood / Q000000981:diagnostic imaging*; D006350:Heart Valve Prosthesis; D006801:Humans; D007205:Indium Radioisotopes; D010973:Platelet Adhesiveness / Q000502:physiology*; D010974:Platelet Aggregation / Q000502:physiology*; D011474:Prosthesis Design; D011664:Pulmonary Valve / Q000002:abnormalities*; D011877:Radionuclide Imaging; D013771:Tetralogy of Fallot / Q000601:surgery*
D007205:Indium Radioisotopes