title: Fate of equine pericardial roll conduit for Rastelli operation during long-term follow-up.
abstract: BACKGROUND
  Right ventricular outflow tract obstruction is a frequent condition after Rastelli operation. Although several modifications have been reported elsewhere, ideal conduit has not been developed yet during long-term follow-up. We reviewed our experiences over 15-year long-term follow-up with patients who underwent Rastelli operation using house-made equine pericardial roll graft.
  
  
  METHODS
  Since June 1981, 16 patients underwent Rastelli operation with the pericardial roll graft. Median follow-up time was 15.6 years (7.3-26.8 years).
  
  
  RESULTS
  Twelve out of 16 patients using pericardial roll graft with (n = 6) or without (n = 6) cusps underwent 13 reoperations during the follow-up period. Median time from first Rastelli to re-do operation was 8.4 years with median time to reoperation of 8 years. Major indication for reoperation was conduit obstruction (n = 10), but not conduit regurgitation. Conduit problem includes kinking and compression of the graft. Reoperation procedures include 7 Danielson procedures, 2 patch augmentations, 1 homograft replacement, 1 pericardial roll graft, 1 expanded polytetrafluoroethylene tube graft replacement, and 1 patch closure for pulmonary artery aneurysm. Balloon angioplasty was not effective for pericardial roll conduit stenosis.
  
  
  CONCLUSIONS
  We conclude that house-made equine pericardial roll graft was durable for certain time period, but conduit change may be inevitable. Because of excellent handling and wide application, further modification may be warranted.
authors: Department of Cardiac Surgery, University of Tokyo Graduate of Medical School, Tokyo, Japan. koutakeuchi-circ@umin.ac.jp
authors: Koh
authors: K
authors: Takeuchi
authors: Arata
authors: A
authors: Murakami
authors: Akihiko
authors: A
authors: Sekiguchi
authors: Yasutaka
authors: Y
authors: Hirata
authors: Katsuhide
authors: K
authors: Maeda
authors: Kazuo
authors: K
authors: Kitahori
authors: Yoshio
authors: Y
authors: Doi
authors: Shin-ichi
authors: S
authors: Takamoto
mesh_terms: D000293:Adolescent; D000328:Adult; D000818:Animals; D001705:Bioprosthesis / Q000009:adverse effects; D006348:Cardiac Surgical Procedures; D005500:Follow-Up Studies; D006736:Horses; D006801:Humans; D053208:Kaplan-Meier Estimate; D010496:Pericardium; D011138:Polytetrafluoroethylene; D019736:Prostheses and Implants; D012086:Reoperation; D013997:Time Factors; D014694:Ventricular Outflow Obstruction / Q000601:surgery*
chemical_list: D011138:Polytetrafluoroethylene