The use of bovine pericardium for pulmonary valve reconstruction or conduit replacement: long-term clinical follow up.
OBJECTIVE
This study aimed to determine the clinical performance of bovine pericardial aldehyde-treated material alone or in combination with aortic leaflets of porcine origin. These were the porcine aortic stentless pulmonary valved bovine pericardial conduit (PSPVC), and porcine aortic monocusp attached to pericardial patch (PAMC), used to correct right-sided heart lesions.


METHODS
Between November 1985 and October 1995, 33 patients underwent corrective congenital surgery with PSPVC. Mean patient age was 5.7+/-4.3 years (range: 15 days to 18 years). Pulmonary atresia with ventricular septal defect (VSD) was the most frequent disease (16/33, 48%). For PAMC, 45 patients with various congenital heart malformations underwent implantation between June 1989 and April 1996. Mean patient age was 4.8+/-4.7 years (range: 2 weeks to 18 years).


RESULTS
With PSPVC, hospital mortality rate was 18.2% and related to poor preoperative clinical condition in six cases. Four patients were lost to follow up; 23 (85%) were followed for 3 months to 10 years (mean 4.8+/-3.0 years). Distal anastomotic scarring in four patients was probably due to retraction of the pericardial tissue. With PAMC, hospital mortality rate was 11% and related to patients' preoperative clinical condition. Three patients were lost to follow up; 37 survivors have been followed for 6 to 88 months (mean 38.5+/-19.0 months). There were no late deaths. Two patients underwent reoperation; intra-operative observation showed well-preserved monocusps with no signs of tissue degeneration. The remaining 35 patients remain asymptomatic by clinical examination and Doppler echocardiography. The monocusps remained mobile in every case.


CONCLUSIONS
PSPVCs have shown excellent performance and durability in young patients with a low mean age (5 years). The monocusp graft has remained functional with good leaflet motion for up to seven years.
Vrandecic
M
M
Biocor Institute, Belo Horizonte, MG, Brazil.
Filho
B G
BG
Fantini
F
F
Barbosa
J
J
Martins
I
I
Cesar de Oliveira
O
O
Martins
C
C
Max
R
R
Drumond
L
L
Oliveira
C
C
Ferrufino
A
A
Alcocer
E
E
Silva
J A
JA
Vrandecic
E
E
D000293:Adolescent; D000818:Animals; D001705:Bioprosthesis; D019917:Blood Vessel Prosthesis Implantation; D002417:Cattle; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006330:Heart Defects, Congenital / Q000601:surgery*; D017052:Hospital Mortality; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D010496:Pericardium / Q000637:transplantation*; D011664:Pulmonary Valve / Q000601:surgery*; D012086:Reoperation; D013552:Swine