Pulmonary ventricular outflow reconstruction with a size-reduced cryopreserved pulmonary valve allograft: mid-term follow-up.
Surgical reduction of pulmonary allografts is being performed because of the shortage of allografts of suitable size for pediatric use. However, the outcome of size-reduced pulmonary allografts for pulmonary conduits is unknown. In the present study, cryopreserved pulmonary allografts harvested from adults at the time of kidney donation were size-reduced and used in 4 children, 2 with pulmonary atresia and ventricular septal defect and 2 with atrioventricular discordance, pulmonary atresia and ventricular septal defect. They all had undergone right and/or left modified Blalock-Taussig shunt operations with a 5-mm synthetic graft prior to the reparative operations. They underwent definitive repair with a size-reduced cryopreserved pulmonary allograft valved conduit and were followed up for 2-5 years. Postoperative echocardiographic and cineangiographic assessments revealed excellent function of the pulmonary bicuspidalized valves with a minimal pressure gradient and no, or only trivial, regurgitation. Although the long-term result of a cryopreserved bicuspid pulmonary valved conduit remains unknown, the remodeled bicuspid pulmonary allograft conduits showed excellent hemodynamic characteristics in mid-term follow-up and appear to be a reasonable alternative to other types of conduits when an appropriate-sized allograft is not available.
Yoshikawa
Y
Y
Department of Surgery III, Nara Medical University, Japan.
Kitamura
S
S
Taniguchi
S
S
Kameda
Y
Y
Niwaya
K
K
Sakaguchi
H
H
D000328:Adult; D001283:Atrioventricular Node / Q000002:abnormalities; D002675:Child, Preschool; D015925:Cryopreservation; D005260:Female; D005500:Follow-Up Studies; D006330:Heart Defects, Congenital / Q000150:complications / Q000601:surgery*; D006345:Heart Septal Defects, Ventricular / Q000150:complications / Q000601:surgery*; D006801:Humans; D008297:Male; D009926:Organ Preservation; D018633:Pulmonary Atresia / Q000150:complications / Q000601:surgery*; D011664:Pulmonary Valve / Q000637:transplantation*; D013997:Time Factors; D020858:Tissue and Organ Harvesting; D014184:Transplantation, Homologous