Downsized cryopreserved and standard-sized allografts for right ventricular outflow tract reconstruction in children: long-term single-institutional experience

Romeo, Jamie L R; Papageorgiou, Grigorios; Woestijne, Pieter C. van de; Takkenberg, Johanna J.M.; Westenberg, Lauren E H; Beynum, Ingrid van; Bogers, Ad J.J.C.; Mokhles, Mostafa M

doi:10.1093/icvts/ivy057

Cited by 6 publications

(5 citation statements)

References 20 publications

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“…Both the mean conduit diameter and the freedom from replacement were comparable in the two groups (14.8 vs. 14.6 mm; 69 vs. 61% at 10 years). Romeo et al reported similar results in patients under 2-yearsold (10). More recently, Francois et al finished another study focused on the comparison between down-sized homograft and other conduits in patients under 3-years-old (28).…”

Section: Clinical Outcomes Of Available Conduits Homograftmentioning

confidence: 78%

“…One way to help deal with the shortage of small-sized conduits is the down-sized technique (8). We were pleased to find that this technique does not affect the the function and durability of the conduits (9,10). There is no doubt that the bovine jugular vein conduit (BJVC), usually known as Contegra R conduit (Medtronic Inc., Minneapolis, Minnesota, USA), has achieved great success.…”

Section: Introductionmentioning

confidence: 99%

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Conduits for Right Ventricular Outflow Tract Reconstruction in Infants and Young Children

et al. 2021

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Purpose of Review: Right ventricular outflow tract (RVOT) reconstruction remains a challenge due to the lack of an ideal conduit. Data and experience are accumulating with each passing day. Therefore, it is necessary to review this topic from time to time. This is a 2021 update review focused on the history, evolution, and current situation of small-sized conduits (≤ 16 mm) for RVOT reconstruction in infants and young children.Recent Findings: Currently, the available small-sized (≤16 mm) conduits can meet most clinical needs. Homograft is still a reliable choice for infants and young children validated by a half-century clinical experience. As an alternative material, bovine jugular vein conduit (BJVC) has at least comparable durability with that of homograft. The performance of expanded polytetrafluoroethylene (ePTFE) is amazing in RVOT position according to limited published data. The past century has witnessed much progress in the materials for RVOT reconstruction. However, lack of growth potential is the dilemma for small-sized conduits. Tissue-engineering based on cell-free scaffolds is the most promising technology to obtain the ideal conduit.Summary: No conduit has proved to have lifelong durability in RVOT position. We are far from the ideal, but we are not in a state of emergency. In-depth clinical research as well as innovation in material science are needed to help improve the durability of the conduits used in infants and young children.

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Section: Clinical Outcomes Of Available Conduits Homograftmentioning

confidence: 78%

Section: Introductionmentioning

confidence: 99%

Conduits for Right Ventricular Outflow Tract Reconstruction in Infants and Young Children

et al. 2021

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“…The main shortcoming of homografts is durability, which appears to be especially limited in young patients. 9 , 10 , 11 It is reasonable to expect most homografts to eventually fail due to severe stenosis, regurgitation, or both. Reports on long-term outcomes after PA-VSD correction emphasizing homograft durability are sparse, but similar high reintervention rates have been reported.…”

Section: Discussionmentioning

confidence: 99%

Homograft durability after correction of pulmonary atresia and ventricular septal defect with or without systemic pulmonary collateral arteries

Woestijne

Romeo

Beynum³

et al. 2021

JTCVS Open

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“…However, when there is no available size, the mid-term followup results show that bicuspidalization can provide an effective alternative compared to xenograft. Other studies have also shown that bicuspidalized valved conduit seems to be a feasible option to solve the problem of limited supply of small size allografts, with acceptable survival rate and reoperation rate (60)(61)(62).…”

Section: Clinical Application Of Homograft Valved Conduitmentioning

confidence: 99%

Application of Homograft Valved Conduit in Cardiac Surgery

Huyan

Chang

Song

2021

Front. Cardiovasc. Med.

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Valved conduits often correct the blood flow of congenital heart disease by connecting the right ventricle to the pulmonary artery (RV-PA). The homograft valved conduit was invented in the 1960s, but its wide application is limited due to the lack of effective sterilization and preservation methods. Modern cryopreservation prolongs the preservation time of homograft valved conduit, which makes it become the most important treatment at present, and is widely used in Ross and other operations. However, homograft valved conduit has limited biocompatibility and durability and lacks any additional growth capacity. Therefore, decellularized valved conduit has been proposed as an effective improved method, which can reduce immune response and calcification, and has potential growth ability. In addition, as a possible substitute, commercial xenograft valved conduit has certain advantages in clinical application, and tissue engineering artificial valved conduit needs to be further studied.

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Downsized cryopreserved and standard-sized allografts for right ventricular outflow tract reconstruction in children: long-term single-institutional experience

Abstract: Bicuspidalization seems to be a viable alternative to combat limited supply of small-sized allografts with acceptable survival and reintervention rates comparable to non-bicuspidalized allografts.

Cited by 6 publications

References 20 publications

Conduits for Right Ventricular Outflow Tract Reconstruction in Infants and Young Children

Conduits for Right Ventricular Outflow Tract Reconstruction in Infants and Young Children

Homograft durability after correction of pulmonary atresia and ventricular septal defect with or without systemic pulmonary collateral arteries

Application of Homograft Valved Conduit in Cardiac Surgery

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