The use and midium-term evaluation of decellularized allograft cusp in the surgical treatment of the tetralogy of fallot.
OBJECTIVE
To describe the technique of implantation and to show the echocardiographic follow-up of the decellularized cusps allografts used in patients with tetralogy of fallot.


METHODS
Fifteen patients underwent this implantation between March 2005 and August 2007 and they were clinically followed-up. An echocardiogram was performed to evaluate the morphofunctional result of the allografts.


RESULTS
The mean follow-up was 12.7 months (1-25 months). The echocardiography results showed that pulmonary insufficiency was mild in nine (60%) patients, moderate in three (20%) patients, and severe in three (20%) patients. The results also showed that the systolic right ventricle function was normal in 13 (86.7%) and that there was mild dysfunction in two (13.3%). Eleven (73.4%) patients did not present any gradient in the right ventricular outflow tract and four (26.6%) presented mild stenosis. The mobility of the cusps were normal in all cases and there was no thickness larger than 1.5 mm. There was no calcification; 14 patients (93.3%) presented Z score between -1 and 0,7 and one patient presented dilated pulmonary annulus with a Z score of + 2.5.


CONCLUSIONS
In midium-term follow-up, the decellularized allograft seemed to be a good option for right ventricle outflow tract enlargement in patients underwent tetralogy of Fallot.
Mulinari
Leonardo Andrade
LA
Departamento de Cirurgia, Universidade Federal do Paraná. dr.mulinari@terra.com.br
Navarro
Fábio Binhara
FB
Pimentel
Gustavo Klug
GK
Miyazaki
Silvia Midori
SM
Binotto
Cristiane Nogueira
CN
Pelissari
Eliana Costa
EC
Miyague
Nelson Itiro
NI
da Costa
Francisco Diniz Affonso
FD
D001024:Aortic Valve Stenosis / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery; D002474:Cell-Free System; D002648:Child; D002675:Child, Preschool; D005500:Follow-Up Studies; D019918:Heart Valve Prosthesis Implantation / Q000295:instrumentation / Q000379:methods* / Q000592:standards; D006801:Humans; D007223:Infant; D011665:Pulmonary Valve Insufficiency / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery; D013771:Tetralogy of Fallot / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D013997:Time Factors; D016896:Treatment Outcome; D014463:Ultrasonography; D018497:Ventricular Dysfunction, Right / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery; D014694:Ventricular Outflow Obstruction / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery; D017725:Ventricular Pressure / Q000502:physiology