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Use of bovine jugular vein to reconstruct the right ventricular outflow tract: early results.
- Source :
-
The Journal of thoracic and cardiovascular surgery [J Thorac Cardiovasc Surg] 2003 Aug; Vol. 126 (2), pp. 490-7. - Publication Year :
- 2003
-
Abstract
- Objective: We evaluate early results of bovine jugular vein conduits in the pulmonary outflow.<br />Methods: Between April 2000 and September 2001, 31 conduits were placed in the outflow of the right ventricle. Patients who received a conduit as a staged surgical procedure were excluded (n = 3). Implantation age ranged from 0 to 21 years (median, 3.4 years). Conduit diameter ranged from 12 to 20 mm (median, 14 mm). Transthoracic echocardiography was performed at discharge and 3 months after surgery. Patients with significant pulmonary regurgitation and/or stenosis underwent cardiac catheterization.<br />Results: Four patients died during the follow-up period. Three deaths were unrelated to the conduit. One death was related to the complete thrombosis of the conduit. At 3 months evaluation, pulmonary valve regurgitation was absent or trivial in 19, mild in 2 and severe in 3 of 24 survivors. Four patients had nonfatal conduit-related complications. A transient thrombus formation within 1 leaflet was noted postoperatively in a patient with a moderate pulmonary regurgitation. Three patients required reoperation 3 to 5.8 months after the implantation for conduit failure (mean, 4.3 months). Cardiac catheterization before replacement revealed an aneurysmal dilation of the conduit below a severe stenosis of the pulmonary bifurcation due to important neointimal proliferation.<br />Conclusions: Early failure of bovine jugular vein valved conduits can occur because of exaggerated intimal proliferation or thrombotic process within the conduit. Because of these complications, close echocardiographic follow-up is mandatory during the first weeks after implantation.
- Subjects :
- Adolescent
Adult
Blood Flow Velocity physiology
Child
Child Welfare
Child, Preschool
Echocardiography, Doppler
Female
Follow-Up Studies
Heart Defects, Congenital mortality
Heart Defects, Congenital surgery
Humans
Infant
Infant Welfare
Infant, Newborn
Male
Postoperative Complications diagnosis
Postoperative Complications etiology
Postoperative Complications mortality
Reoperation
Severity of Illness Index
Survival Analysis
Time Factors
Treatment Outcome
Ventricular Dysfunction, Right diagnosis
Ventricular Dysfunction, Right etiology
Ventricular Outflow Obstruction mortality
Ventricular Pressure physiology
Cardiac Surgical Procedures
Jugular Veins surgery
Ventricular Outflow Obstruction surgery
Subjects
Details
- Language :
- English
- ISSN :
- 0022-5223
- Volume :
- 126
- Issue :
- 2
- Database :
- MEDLINE
- Journal :
- The Journal of thoracic and cardiovascular surgery
- Publication Type :
- Academic Journal
- Accession number :
- 12928649
- Full Text :
- https://doi.org/10.1016/s0022-5223(03)00232-0