Bicuspidized pulmonary homograft for truncus arteriosus repair.
Primary repair is preferable to palliation in infants with truncus arteriosus. At our institute, an appropriately small homograft valved conduit is not available for every patient; a bicuspidized pulmonary valve homograft is an alternative. Between December 1996 and August 2005, 24 patients aged 28 days to 21 months with truncus arteriosus underwent primary repair with a homograft valved conduit; bicuspidized homografts were used in 15 of them. In the 18 (75%) patients who survived to hospital discharge, 5-year survival was 94% (75% for tricuspid homografts and 100% for bicuspidized homografts, which was not significantly different). Freedom from reoperation or balloon angioplasty in all 18 survivors was 89% at 5 years. Freedom from reoperation in tricuspid and bicuspidized homograft groups at 5 years was 67% and 100%, respectively; the difference was not statistically significant. Bicuspidized homografts worked as well as tricuspid conduits in the intermediate term. The remodeled homografts showed excellent hemodynamic characteristics and appear to be a reasonable alternative when an appropriate size of valved homograft is unavailable.
Department of Surgery, King Chulalongkorn Memorial Hospital, Chulalongkorn University, Rama IV Road, Pratumwan, Bangkok 10330, Thailand. vichaicu@hotmail.com
Vichai
V
Benjacholamas
Jule
J
Namchaisiri
Apichai
A
Khongphatthanayothin
Pornthep
P
Lertsapcharoen
D001011:Aorta / Q000637:transplantation; D001807:Blood Vessel Prosthesis; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D011474:Prosthesis Design; D011651:Pulmonary Artery / Q000637:transplantation*; D011664:Pulmonary Valve / Q000637:transplantation*; D015996:Survival Rate; D016896:Treatment Outcome; D014261:Tricuspid Valve / Q000637:transplantation*; D014339:Truncus Arteriosus, Persistent / Q000150:complications / Q000401:mortality / Q000601:surgery*