Eight years of pulmonary valve replacement with a suggestion of a promising alternative

Abstract

Although the follow-up for the Perimount valves was short, they are promising and need to be followed long-term. The homograft and the Monocusp remain valuable choices.

Outcomes in adult congenital heart surgery: Analysis of the Society of Thoracic Surgeons Database

“…The mortality for pulmonary valve replacement was lower than that reported in a study from Norway, which included 79 patients over the age of 17 receiving a pulmonary valve replacement with overall early mortality of 2.7%. 22 Shinkawa et al analyzed 73 patients undergoing pulmonary valve replacement and reported zero perioperative deaths. 23 Mortality for atrial septal defect repair was zero in our study and has previously been reported to be 0–1.2%.…”

Outcomes of truncus arteriosus repair with bovine jugular vein conduit

“…[16] It was also reported that the Contegra conduit responded better to catheter interventions, when stenosis developed. Neukamm et al [17] described that necessity for reoperations within the first two years was significantly lower for Contegra grafts than for non-blood group compatible cryopreserved homografts, two of 78 (2.6%) and eight of 20 (40.0%), respectively. However, there are also studies reporting that distal anastomotic stenosis after the Contegra use is more frequent, and that some conduits may lead to pulmonary insufficiency associated with significant conduit dilatation.…”

O conduto valvulado bovino contegra, um biomaterial para o tratamento cirúrgico de cardiopatias congênitas

“…Structural deterioration of the Contegra graft may be seen in small number of patients (5.1%) 31 . Necessity for reoperations within the first 2 years was significantly lower for Contegra grafts than for non-blood group compatible cryopreserved homografts, 2 of 78 (2.6%) and 8 of 20 (40.0%), respectively 33 . Contegra grafts had reoperations due to insufficiency in only 6%, however, reoperations were mainly due to peripheral pulmonary stenosis at the distal anastomosis and aneurysms 34 .…”

“…Conduit plasty was necessary in 6 (0.4%), and reintervention to the conduit or to the pulmonary arteries in 83 (4.9%) patients. The conduit reimplantation was due to severe stenosis (excessive gradient) of the distal anastomosis refractory to interventional treatment 9,14,24,33,35 , (pseudo)aneurysm of the proximal anastomosis 19 , progressive right ventricular dysfunction caused by severe conduit regurgitation 18,20,33 , endocarditis 11,35 or graft degeneration 35 .…”

“…The Contegra was used as a tube graft in the pulmonary position in 1635 (95.9%) patients, of whom a patch closure of the VSD using a segment from the same Contegra material was done in 11 patients 26 . The Contegra was tailored as a monocuspid valved transannular patch in 12 (0.7%) 22 , as a tube graft in the position of the pulmonary valve for pulmonary valve replacements and as a monocusp in 40 (2.3%) 33 , and as an inferior vena cava-pulmonary artery conduit in the Fontan procedure in 18 (1.1%) patients 27 , respectively.…”