title: Performance of right ventricle to pulmonary artery conduits after repair of truncus arteriosus: a comparison of Dacron-housed porcine valves and cryopreserved allografts.
abstract: Repair of complex congenital heart defects often requires the use of extracardiac conduits. These repairs can be technically accomplished with excellent early results. However, the long-term performance of various conduits is less than optimal. In this report, we examined the long-term outcome of xenograft valved Dacron conduits and cryopreserved allograft valved conduits used for reconstruction of the right ventricular outflow tract in young patients with truncus arteriosus. A retrospective review was performed on 222 patients who underwent primary surgical repair of truncus arteriosus between January 1975 and December 1994 using a xenograft valved synthetic conduit (group I; n = 175) or with a cryopreserved valved allograft conduit (group II; n = 47). Median age at repair was 121 days in group I and 70 days in group II; median weight of patients in both groups was the same (4.2 kg). Conduit-related early deaths occurred in 5.7% (10/175) of patients in group I and none in group II. In a cohort of age-matched patients, actuarial freedom from conduit-related reintervention at 5 years follow-up was significantly better (P = .037) for the cryopreserved valved allograft conduits when compared with xenograft valved synthetic conduits. However, this difference was not apparent by 7 years. Multivariate analysis showed conduit size (P = .0005) as a significant predictor of early conduit-related reintervention. This study shows that mid-term performance of cryopreserved allografts (which have the advantage of technical ease of insertion of availability of small sizes for use in neonates), is better than the xenograft Dacron conduits.(ABSTRACT TRUNCATED AT 250 WORDS)
authors.affiliation: Division of Cardiothoracic Surgery, University of California San Francisco, USA.
authors.forename: V M
authors.initials: VM
authors.lastname: Reddy
authors.forename: H A
authors.initials: HA
authors.lastname: Rajasinghe
authors.forename: D B
authors.initials: DB
authors.lastname: McElhinney
authors.forename: F L
authors.initials: FL
authors.lastname: Hanley
mesh_terms: D000714:Anastomosis, Surgical; D001807:Blood Vessel Prosthesis; D001808:Blood Vessels / Q000637:transplantation*; D015925:Cryopreservation; D005500:Follow-Up Studies; D006350:Heart Valve Prosthesis; D006801:Humans; D007223:Infant; D011093:Polyethylene Terephthalates; D012086:Reoperation; D012189:Retrospective Studies; D013997:Time Factors; D014184:Transplantation, Homologous; D016896:Treatment Outcome; D014339:Truncus Arteriosus, Persistent / Q000601:surgery*
chemical_list: D011093:Polyethylene Terephthalates