Autologous pericardial pulmonary conduit with single point attached commissures in a sheep model.
OBJECTIVE
For the surgical treatment of congenital heart disease and in Ross procedure a valved conduit is frequently required. Since homografts are not readily available in every country, a reliable alternative is needed. We developed a novel technique to construct a valved pulmonary conduit with single point attached commissures (SPAC) in a simple and fast way from a small strip of autologous pericardium, molded and briefly treated with glutaraldehyde.


METHODS
Autologous pericardial pulmonary conduit was constructed intraoperatively and implanted in pulmonary position in a beating heart in six sheep. The prosthesis size was 31 mm for all sheep and the construction time (including 10 min glutaraldehyde treatment) was 19.0+/-3.3 min. Implantation time and cardiopulmonary by-pass was 27.3+/-5.4 min and 40.5+/-7.7 min, respectively. The sheep were euthanized after 6 months (222.7+/-5.8 days) postoperatively.


RESULTS
In all sheep, the autologous pericardial valve was immediately competent. At sacrifice, the pericardial valve was pliable and competent in all cases with SPAC well anchored to the pericardial conduit wall. The maximum transvalvular gradient at implant and at sacrifice was 3.3+/-2.8 mmHg and 3.3+/-2.0 mmHg, respectively.


CONCLUSIONS
This novel autologous pericardial pulmonary conduit with SPAC can be reliably produced in a very short time intraoperatively before cardiopulmonary by-pass. The simplicity of construction, biocompatibility and freedom of stenosis or thrombosis makes this autologous pulmonary conduit especially useful for patients at locations where homografts are not readily available.
Department of Cardiovascular Surgery, German Heart Center at the Technical University Munich, Lazarettstr. 36, 80636 Munich, Germany. goetz@dhm.mhn.de
Wolfgang A
WA
Goetz
Teing Ee
TE
Tan
Khee Hiang
KH
Lim
Fangli
F
Xiong
Sidney Le Hung
Sle H
Salgues
Nil
N
Grousson
Yeow Leng
YL
Chua
Joon Hock
JH
Yeo
D000818:Animals; D003432:Cross-Linking Reagents / Q000008:administration & dosage; D004452:Echocardiography; D005976:Glutaral / Q000008:administration & dosage; D006330:Heart Defects, Congenital / Q000601:surgery*; D006350:Heart Valve Prosthesis; D019918:Heart Valve Prosthesis Implantation / Q000379:methods*; D010496:Pericardium / Q000601:surgery*; D011474:Prosthesis Design / Q000592:standards; D012756:Sheep; D014182:Transplantation, Autologous; D016896:Treatment Outcome
D003432:Cross-Linking Reagents; D005976:Glutaral