1. Right ventricular outflow tract reconstruction with the Labcor® stentless valved pulmonary conduit
- Author
-
Peter Dütschke, Jill Jussli-Melchers, Hans-Heiner Kramer, Jens Scheewe, J. Logoteta, Christina Grothusen, Inga Voges, Julia Steer, Jan Hinnerk Hansen, Tim Attmann, University of Zurich, and Jussli-Melchers, Jill
- Subjects
Heart Defects, Congenital ,Reoperation ,Pulmonary and Respiratory Medicine ,medicine.medical_specialty ,Adolescent ,Swine ,Heart Ventricles ,610 Medicine & health ,030204 cardiovascular system & hematology ,2705 Cardiology and Cardiovascular Medicine ,Ventricular Outflow Obstruction ,03 medical and health sciences ,0302 clinical medicine ,Electrical conduit ,Interquartile range ,medicine.artery ,medicine ,Animals ,Humans ,Ventricular outflow tract ,cardiovascular diseases ,Child ,Retrospective Studies ,Tetralogy of Fallot ,Bioprosthesis ,business.industry ,Infant ,General Medicine ,Perioperative ,medicine.disease ,2746 Surgery ,Cardiac surgery ,Surgery ,Stenosis ,Treatment Outcome ,10036 Medical Clinic ,2740 Pulmonary and Respiratory Medicine ,Child, Preschool ,Heart Valve Prosthesis ,030220 oncology & carcinogenesis ,Pulmonary artery ,cardiovascular system ,Cattle ,Cardiology and Cardiovascular Medicine ,business - Abstract
OBJECTIVES The right ventricular outflow tract reconstruction is a common necessity in congenital cardiac surgery. As homograft availability is limited, alternatives need to be evaluated. The Labcor® conduit consists of a porcine tricomposite valve assembled inside a bovine pericardium tube. This study presents intermediate-term results for its utilization for right ventricular outflow tract reconstruction. METHODS Labcor conduits were implanted in 53 patients (February 2009–July 2016). We analysed perioperative data, freedom from conduit failure and risk factors for conduit dysfunction. RESULTS The most common diagnosis was Tetralogy of Fallot (n = 20, 37.7%). The median age at surgery was 10.0 [interquartile range (IQR) 4.9–14.3] years. Pulmonary artery plasty (n = 37, 69.8%) and augmentation of the right ventricular outflow tract (n = 16, 30.2%) were often part of the procedure. The median conduit size was 21 (range 11–25) mm. There was no in-hospital death. The median follow-up after surgery was 4.6 (IQR 3.4–5.6) years. Fourteen patients (27.5%) developed conduit failure with stenosis being the main cause. Freedom from conduit failure was 98.0% at 2 and 80.5% at 5 years. The median longevity of the conduit was 7.4 years (95% confidence interval 5.1–9.8 years). Younger age and smaller conduit size were related to conduit failure. CONCLUSIONS Utilization of the Labcor conduit revealed acceptable intermediate-term results. The conduit appeared to be functioning sufficiently well within the first 5 years in the majority of patients. The higher rate of failure concerning smaller conduits might be associated with somatic outgrowth; however, conduit degeneration as common and long-term outcome still needs to be evaluated.
- Published
- 2019
- Full Text
- View/download PDF