title: The use and midium-term evaluation of decellularized allograft cusp in the surgical treatment of the tetralogy of fallot.
abstract: 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.
authors.affiliation: Departamento de Cirurgia, Universidade Federal do Paraná. dr.mulinari@terra.com.br
authors.forename: Leonardo Andrade
authors.initials: LA
authors.lastname: Mulinari
authors.forename: Fábio Binhara
authors.initials: FB
authors.lastname: Navarro
authors.forename: Gustavo Klug
authors.initials: GK
authors.lastname: Pimentel
authors.forename: Silvia Midori
authors.initials: SM
authors.lastname: Miyazaki
authors.forename: Cristiane Nogueira
authors.initials: CN
authors.lastname: Binotto
authors.forename: Eliana Costa
authors.initials: EC
authors.lastname: Pelissari
authors.forename: Nelson Itiro
authors.initials: NI
authors.lastname: Miyague
authors.forename: Francisco Diniz Affonso
authors.initials: FD
authors.lastname: da Costa
mesh_terms: 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