title: Percutaneous balloon dilation of Carpentier-Edwards porcine-valved right ventricle-to-pulmonary artery conduits.
abstract: Right ventricular outflow tract (RVOT) conduit stenosis remains a significant problem for patients with right ventricle-to-pulmonary artery (RV-to-PA) conduits placed as palliation for congenital heart disease. Previous reports on balloon dilation of RVOT conduits all describe small series with varying levels of success during limited follow-up evaluation. This study reviewed all patients with RV-to-PA conduits who underwent percutaneous balloon dilation for conduit stenosis at the authors' institution from 2000 to 2011. Patients with Carpentier-Edwards (CE) model 4300 porcine-valved conduits (Edwards Lifesciences Corp., Irvine, CA) (n = 19) were compared with patients who had all other types of conduits (n = 19). Successful balloon angioplasty was defined as a 20 % decrease in the RV-to-PA gradient, a 20 % decrease in the ratio of the RV systolic-to-aortic systolic pressure, or both. Balloon dilation was successful for 57.9 % of the patients with CE conduits and for 31.6 % of patients with other types of conduits (p = 0.10, Chi square test). Logistic regression analysis showed that balloon dilation was significantly more likely to be successful with CE valves than with other types (odds ratio [OR], 6.59; 95 % confidence interval [CI], 1.22-35.49). In a continuous series of patients with stenotic RV-to-PA conduits, the CE porcine-valved conduit was more amenable to percutaneous balloon dilation than other types of RV-to-PA conduits at the midterm follow-up evaluation. This has important ramifications in terms of valve selection for patients with congenital heart disease who will require surgical reintervention for RVOT stenosis.
authors.affiliation: Pediatric Cardiac Consortium of Upstate New York, Rochester, NY, USA. amandac.hall23@gmail.com
authors.forename: Amanda C
authors.initials: AC
authors.lastname: Hall
authors.forename: Daniel E
authors.initials: DE
authors.lastname: Miga
authors.forename: Glenn T
authors.initials: GT
authors.lastname: Leonard
authors.forename: Hongyue
authors.initials: H
authors.lastname: Wang
authors.forename: Rae-Ellen
authors.initials: RE
authors.lastname: Kavey
authors.forename: George M
authors.initials: GM
authors.lastname: Alfieris
mesh_terms: D000293:Adolescent; D015906:Angioplasty, Balloon, Coronary; D000818:Animals; D001705:Bioprosthesis; D001807:Blood Vessel Prosthesis; D006328:Cardiac Catheterization; D016009:Chi-Square Distribution; D002648:Child; D002675:Child, Preschool; D005260:Female; D006083:Graft Occlusion, Vascular / Q000601:surgery*; D006330:Heart Defects, Congenital / Q000601:surgery*; D006352:Heart Ventricles / Q000601:surgery*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D016015:Logistic Models; D008297:Male; D011651:Pulmonary Artery / Q000601:surgery*; D012189:Retrospective Studies; D013552:Swine; D014694:Ventricular Outflow Obstruction / Q000601:surgery*