Long-term follow-up of autologous pericardial valved conduits.
BACKGROUND
The aim of this study was to evaluate the long-term results of the use of an autologous pericardial valved conduit in the outflow tract of the venous ventricle in congenital heart malformations.


METHODS
Fifty-one patients were followed up for a period of 12 to 120 months; 30 for more than 36 months and 13 for more than 72 months. All were evaluated clinically and by two-dimensional and Doppler echocardiography. Eight patients were recatheterized. Postoperative evaluation included serial measurement of pressure gradients and the conduit's diameter at the proximal, valvular, and distal levels. Reoperation because of stenosis was indicated when the gradient across the right ventricular outflow was greater than 50 mm Hg. The reoperation rate in relation with postoperative time, diameter of the autologous pericardial valved conduit at the time of implantation, and malformation was statistically analyzed.


RESULTS
In 27 patients the conduit increased its diameter 1 to 7 mm. In 20 patients the diameter remained unchanged, whereas a reduction was noted in 4. Conduit survival free of reoperation for the whole group was 89.9% at 5 years. Conduit survival free of reoperation was 100% at 5 and 7 years for conduits larger than 16 mm at the time of implantation. It was 95% (standard deviation = 4.8%) at 5 years and 72.3% at 7 years for those 16 mm or less. For patients operated after January 1, 1986 (technical modification), conduit survival free of reoperation was 95.4% at 7 years postoperatively.


CONCLUSIONS
These results compare favorably with those of other available conduits.
Schlichter
A J
AJ
Division of Pediatric Cardiac Surgery and Cardiology, Hospital de Niños Ricardo Gutierrez, Buenos Atres, Argentina.
Kreutzer
C
C
Mayorquim
R C
RC
Simon
J L
JL
Vazquez
H
H
Roman
M I
MI
Kreutzer
G O
GO
D001807:Blood Vessel Prosthesis; D002675:Child, Preschool; D004452:Echocardiography; D015150:Echocardiography, Doppler; D005260:Female; D005500:Follow-Up Studies; D006085:Graft Survival; D006330:Heart Defects, Congenital / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000601:surgery*; D006801:Humans; D015994:Incidence; D007223:Infant; D008297:Male; D010496:Pericardium / Q000637:transplantation*; D011183:Postoperative Complications / Q000000981:diagnostic imaging / Q000453:epidemiology; D011651:Pulmonary Artery / Q000601:surgery*; D012086:Reoperation; D013536:Suture Techniques; D013997:Time Factors; D014182:Transplantation, Autologous; D014694:Ventricular Outflow Obstruction / Q000601:surgery