title: A Novel Designed Valved Conduit for RVOT Reconstruction in Grown-up Congenital Heart Patients: a Glimpse Down the Road.
abstract: BACKGROUND
  A plethora of valves and valve conduits are available for reconstruction of the right ventricular outflow tract (RVOT) for grown-up congenital heart patients. However, for several reasons, the ideal pulmonary valve substitute still remains the subject of debate. In this study, we investigated the preliminary clinical and echocardiographic results after implantation of the RVOT Elan (Vascutek, Renfrewshire, United Kingdom) conduit in adolescents and adults.
  
  
  METHODS
  Between October 2012 and December 2014, a total of 27 patients (19 males, mean age: 23.7 ± 22.5; range: 9-74 years) received a RVOT Elan conduit for RVOT reconstruction and were prospectively followed up clinically and echocardiographically. Twenty-five patients had previous cardiac surgery. The median number of prior operations per patient was 2 (range: 1-4). Tetralogy of Fallot was the most common diagnosis (n = 7).
  
  
  RESULTS
  At a mean follow-up time of 0.9 ± 0.61 years (100% complete), all patients (27 of 27) were alive and in New York Heart Association Class I. Adverse events defined as valve failure, thrombosis, embolism, bleeding, or endocarditis did not occur. Freedom from reoperation in general was 100%. At 1-year follow-up, median peak pressure gradients (Δ Pmax) across the RVOT Elan conduit were 15 ± 3.2; 15.3 ± 2.1Δ, 16 ± 4.8, and 16.3 ± 5.1 mm Hg for the 19 (n = 3), 21 (n = 3), 23 (n = 6), and 25 mm (n = 15) conduit size, respectively.
  
  
  CONCLUSIONS
  The RVOT Elan conduit revealed excellent preliminary clinical and hemodynamic performances independent from the underlying cardiac pathology with insignificant transvalvular gradients and nonturbulent flow characteristics.
authors.affiliation: Department of Cardiac Surgery, Sana Cardiac Surgery, Stuttgart, Germany.
authors.forename: Markus
authors.initials: M
authors.lastname: Liebrich
authors.affiliation: Department of Cardiac Surgery, Sana Cardiac Surgery, Stuttgart, Germany.
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Hemmer
authors.affiliation: Department of Pediatric Cardiology/Pulmonology and Intensive Care Medicine, Olgahospital, Stuttgart, Germany.
authors.forename: Frank
authors.initials: F
authors.lastname: Uhlemann
authors.affiliation: Department of Cardiac Surgery, Sana Cardiac Surgery, Stuttgart, Germany.
authors.forename: Constanze
authors.initials: C
authors.lastname: Merz
authors.affiliation: Department of Cardiac Surgery, Sana Cardiac Surgery, Stuttgart, Germany.
authors.forename: Wladimir
authors.initials: W
authors.lastname: Voth
authors.affiliation: Department of Cardiac Surgery, Sana Cardiac Surgery, Stuttgart, Germany.
authors.forename: Michael
authors.initials: M
authors.lastname: Scheid
authors.affiliation: Department of Cardiac Surgery, Sana Cardiac Surgery, Stuttgart, Germany.
authors.forename: Ioannis
authors.initials: I
authors.lastname: Tzanavaros
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001705:Bioprosthesis; D001807:Blood Vessel Prosthesis; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects / Q000295:instrumentation*; D002648:Child; D005260:Female; D006330:Heart Defects, Congenital / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery*; D006350:Heart Valve Prosthesis; D019918:Heart Valve Prosthesis Implantation / Q000009:adverse effects / Q000295:instrumentation*; D006439:Hemodynamics; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology; D011474:Prosthesis Design; D011651:Pulmonary Artery / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000637:transplantation*; D011664:Pulmonary Valve / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000637:transplantation*; D012086:Reoperation; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult