Long-term follow-up of patients with synthetic right heart conduits.
Between 1971 and 1983, 201 patients received synthetic right heart conduits, predominantly porcine-valved Dacron conduits, at The Children's Hospital, Boston. There were 45 hospital deaths (22%). Follow-up has been achieved in 148 of 156 survivors (95%). Thirty-four conduits have been replaced, all because of conduit obstruction. The actuarial freedom from conduit replacement was 81% at 5 years, 61% at 7 years, and 0% at 10 years for valved conduits. There was no significant difference to 5 years in reoperation rate between patients with Carpentier-Edwards and those with Hancock conduits. Patients older than 18 years at the time of conduit insertion were 92% free of conduit replacement at 5 years. Those with nonvalved conduits were 100% reoperation free at 4 years. The actuarial survival of patients with valved conduits was 91% at 5 years and 83% at 10 years. The poor performance of porcine-valved tightly woven Dacron conduits warrants a change to use of an alternative conduit, particularly in smaller children. Possible alternatives include antibiotic-sterilized homografts and valved or nonvalved high-porosity knitted Dacron conduits appropriately pretreated with collagen impregnation or fibrin glue.
Jonas
R A
RA
Freed
M D
MD
Mayer
J E
JE
Castaneda
A R
AR
D000206:Actuarial Analysis; D001705:Bioprosthesis / Q000009:adverse effects; D002648:Child; D005500:Follow-Up Studies; D006330:Heart Defects, Congenital / Q000601:surgery*; D006345:Heart Septal Defects, Ventricular / Q000601:surgery; D006350:Heart Valve Prosthesis / Q000009:adverse effects; D006801:Humans; D011093:Polyethylene Terephthalates; D011664:Pulmonary Valve / Q000002:abnormalities / Q000601:surgery*; D011666:Pulmonary Valve Stenosis / Q000601:surgery; D013771:Tetralogy of Fallot / Q000601:surgery; D013997:Time Factors
D011093:Polyethylene Terephthalates