The Annals of Thoracic Surgery, Vol 31, 437-443, Copyright © 1981 by The Society of Thoracic Surgeons
Late results of reconstruction of the right ventricular outflow tract with porcine xenografts in children
GS Bisset 3d, DC Schwartz, G Benzing 3d, J Helmsworth, JT Schreiber and S Kaplan
Thirty-three children, aged 2.5 to 17.5 years (mean, 8.3 years), having
xenograft external conduits placed between the right ventricle and
pulmonary artery were followed for 1 to 6 years postoperatively (mean, 3.5
years). There were no late deaths in the study group, and no infection of a
valved conduit has been demonstrated. Twenty of these children were
catheterized during the follow-up period. The gradients from the right
ventricle to pulmonary artery ranged from 8 to 90 mm Hg (average, 31 mm
Hg). A total of 8 patients were classified as having hemodynamically
documented conduit failure, and an additional 2 patients are clinically
expected to have conduit failure. This represents a total incidence of 30%
xenograft conduit failure in a 6- year follow-up. Although the etiology of
this dysfunction is probably multifactorial, factors such as valve size,
conduit angulation, and immunological competence bear special
consideration. We conclude that although valved external conduits continue
to play an important role in the treatment of complex congenital heart
disease, a valved conduit with greater longevity is needed for use in
children.
