Análise inicial do uso de enxerto tubular orgânico L-D-Hydro - (Eato L-D-Hydro) para realização de Blalock-Taussig modificado nas cardiopatias congênitas com hipofluxo pulmonar

Abstract

ObjectiveTo analyze the initial results of the use of an organic tubular graft for systemic-pulmonary anastomoses. MethodsFrom March 2002 to April 2003, 10 patients underwent systemic-pulmonary shunt of the modified Blalock-Taussig type, using a new type of biological graft originating from the bovine mesenteric artery treated with polyglycol, the so-called L-D-Hydro. The patients' ages ranged from 3 days to 7 years, and 60% of them were of the male sex. The diagnoses of heart disease were determined on echocardiography. All patients had clinical signs of severe hypoxia (cyanosis). The heart diseases were as follows: tetralogy of Fallot (40%), tricuspid atresia (50%), and atrioventricular septal defect (10%). ResultsOne patient died due to sepsis and 9 had an immediate improvement in O 2 saturation on pulse oximetry and in the partial oxygen pressure on arterial blood gas analysis. The intensive care unit length of stay ranged from 2 to 6 days. No patient had obstruction of the shunt on the immediate postoperative period or any other complication. All patients had a patent shunt on the echocardiographic studies performed in the immediate postoperative period and later, in the third postoperative month. No bleeding occurred during surgery or in the postoperative period. ConclusionThe tubular L-D-Hydro graft proved to be promising for performing systemic-pulmonary shunt as an alternative for the inorganic products available in the market, however, we need a greater number of implantations and late follow-up for definitive assessment. Key wordssystemic-pulmonary anastomosis, modified Blalock-Taussig The systemic-pulmonary shunt using blood flow from the subclavian artery to the ipsilateral pulmonary artery was clinically introduced by Blalock and Taussig 1. Potts et al 2 have reported the performance of a shunt between the descending aorta and the pulmonary artery, Waterston 3 has created a shunt between the ascending aorta and the pulmonary artery, and Redo and Ecker 4 have introduced the use of a prosthesis for performing a systemic-pulmonary shunt.We present the initial analysis of the results with 10 patients undergoing systemic-pulmonary shunt with a new type of organic graft (L-D-Hydro) originating from the bovine mesenteric artery treated with polyglycol.