title: The Hancock external valved conduit. A dichotomy between late clinical results and late cardiac catheterization findings.
abstract: The Hancock external valved conduit was inserted in 18 children between 1974 and 1977. Seventeen patients survived operation and 15 are long-term survivors of 6 to 9 years. All patients have been closely followed up by the same pediatric cardiologist and each has undergone serial cardiac catheterization studies, generally performed at 1 and 6 years after operation. All long-term surviving patients have been in either New York Heart Association Class I or II. A few continue to take digoxin or diuretics. Cardiac catheterization demonstrated a gradient of 50 mm Hg or greater across the conduit in two of 16 patients 1 year after operation and in seven of 15 patients 6 years after operation. Five patients (30% of all long-term survivors) have had this conduit replaced and each has survived reoperation. The finding of a severe conduit gradient in one third of all long-term surviving patients is particularly bothersome since these patients were essentially asymptomatic. This study emphasizes the need for serial follow-up cardiac catheterization studies in all patients who receive the Hancock conduit.
mesh_terms: D000293:Adolescent; D001705:Bioprosthesis; D001807:Blood Vessel Prosthesis; D006328:Cardiac Catheterization; D002648:Child; D002675:Child, Preschool; D005500:Follow-Up Studies; D006330:Heart Defects, Congenital / Q000601:surgery*; D006345:Heart Septal Defects, Ventricular / Q000601:surgery; D006350:Heart Valve Prosthesis; D006801:Humans; D007223:Infant; D011183:Postoperative Complications / Q000401:mortality; D011651:Pulmonary Artery / Q000601:surgery; D012086:Reoperation; D013771:Tetralogy of Fallot / Q000601:surgery; D014188:Transposition of Great Vessels / Q000601:surgery