Mid-term outcome of handmade trileaflet polytetrafluoroethylene valved-conduit with sinus for severe post correction pulmonary regurgitation.
- #CH/ADU 01-EP-5
- Congenital Heart Surgery/Adult Congenital Cardiac. E-POSTER (ORAL) SESSION
- E-Poster (oral)
Mid-term outcome of handmade trileaflet polytetrafluoroethylene valved-conduit with sinus for severe post correction pulmonary regurgitation.
Chung-i Chang 1, Kang-Hong Hsu 1, Te-I Chang 2
1 Mackay Memorial Hospital, Taipei, Taiwan; 2 Wanfang Hospital, Taipei, Taiwan;
Date, time and location: 2018.05.26 15:30, Exhibition area, 1st Floor. Zone – D
Abstract
Redo RVOT reconstruction with pulmonary valve replacement seems to be inevitable for TOF patients with severe post correction pulmonary regurgitation. No ideal prosthesis has been recommended. We report our mid-term outcome with a novel, efficient handmade trileaflet PTFE valved-conduit with sinus for RVOT reconstruction.
Material and method
From October 2010 to November 2017, fifty patients (32 males and 18 female) with severe pulmonary regurgitation after total correction of TOF needed either pulmonary valvuloplasty or replacement with RVOT reconstruction. The age at redo operation was between 10 and 49 years old (mean 15.08 year). The mean follow-up period was 4.23 years. Six patients received redo pulmonary valvuloplasty (4 bicuspidalization, 1 valve leaflet extension, and 1 monocuspid patch made with PTFE surgical membrane). Forty-four patients underwent pulmonary valve replacement, (1 xenograft, 43 with handmade valved-conduit replacements). The concomitant RVOT reconstruction with excision of RVOT redundant patch or aneurysm were performed. The echocardiography was done immediately post-surgery. Every 6 months during the follow up period, additional echocardiography, along with EKG and Serum BNP. The MRI was administrated every 2 years for the RV remodeling.
Result
There was one surgical mortality due to postoperative RV failure and no late death. Postoperative echocardiography revealed 8 none, 10 trivial, 18 mild, 5 moderate, 1 moderate to severe, and 1 severe residual PR. Decrease in QRS durations averaged 10ms in the 2 years after redo operation. BNP returned to normal. The MRI data was insufficient for analysis, but RVEDV1 has decreased.
Conclusion
Redo pulmonary valve replacement with handmade valved-conduit with sinus is a feasible and acceptable alternative choice. The long term result will need to be evaluated.