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Right ventricular outflow tract reconstruction with the Labcor® stentless valved pulmonary conduit

Authors :
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
Jussli-Melchers, Jill
Source :
European Journal of Cardio-Thoracic Surgery.
Publication Year :
2019
Publisher :
Oxford University Press (OUP), 2019.

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.

Details

ISSN :
1873734X and 10107940
Database :
OpenAIRE
Journal :
European Journal of Cardio-Thoracic Surgery
Accession number :
edsair.doi.dedup.....2730c594f6d6d10069832c0e71b7d203
Full Text :
https://doi.org/10.1093/ejcts/ezz200