Long-Term Follow-Up of Right Ventricle to Pulmonary Artery Biologic Valved Conduits Used in Pediatric Congenital Heart Surgery

Lewis, Michael J.; Malm, Torsten; Hallbergson, Anna; Nilsson, Fredrik; Ramgren, Jens Johansson; Tran, Kiet A.; Liuba, Petru

doi:10.1007/s00246-022-02956-3

Cited by 11 publications

(9 citation statements)

References 33 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Clearly, in this setting, one has to remind that the patients are older when they receive their second graft. The results are also consistent with Lewis et al, which demonstrated no evidence for a shorter life span of the second graft (Lewis et al 2023 ).…”

Section: Discussionsupporting

confidence: 91%

Clinical experience of reoperative right ventricular outflow tract reconstruction with valved conduits: risk factors for conduit failure in long-term follow-up

et al. 2023

View full text Add to dashboard Cite

Reconstruction of right ventricular outflow tract in patients with congenital heart disease in various age groups remains a controversial issue. Currently, a little is known about the fate of secondary and subsequent conduit. The aim of the study was to determine risk factors of conduit failure, evaluate long-term conduit survival, find out which type of conduit should be preferred in case of reoperations. We performed a retrospective analysis of a total of 249 records of valved conduit secondary and subsequent replacement in right ventricular outflow tract in 197 patients. Median follow-up was 5.7 years. The study endpoints were defined as conduit explants; balloon dilatation of the graft (excluding balloon dilatation of left/right pulmonary artery), transcatheter pulmonary valve implantation; heart transplantation or death of the patient. There were total of 21 deaths (11% mortality) among 197 patients during the follow-up, 2 patients underwent heart transplant, in 23 implanted conduits pulmonary angioplasty or/including transcatheter pulmonary valve implantation was afterwards performed due to graft failure, conduit had to be explanted in 46 cases. After 28 years follow-up, freedom from graft failure after 5 years was 77%, 48% after 10 years and 21% after 15 years. Reoperative right ventricular outflow tract reconstruction demonstrates good mid-term and acceptable long-term outcomes regardless of the type of conduit implanted. Worse long-term graft survival of secondary and further conduits is associated with younger age of the recipient at implantation, small size of the conduit, younger age of donor and male donor in case of allograft implantation.

show abstract

Section: Discussionsupporting

confidence: 91%

Clinical experience of reoperative right ventricular outflow tract reconstruction with valved conduits: risk factors for conduit failure in long-term follow-up

et al. 2023

View full text Add to dashboard Cite

show abstract

“…Although the conclusions of material influence were inconsistent, most studies confirmed that the durability of PHG was significantly longer than those of xenograft and AHG. Besides, many studies found small conduit size, young age, and low-weight of the patient to be risk factors for conduit failure [7,8,10,11]. In our opinion, although these were reasonable risk factors for conduit stenosis, they cannot fully explain the mechanism underlying stenosis progress.…”

Section: Mechanism Of Conduit Stenosismentioning

confidence: 69%

“…We combined the AHGs and PHGs into Homografts for baseline data and multivariate analysis. However, in some previous large sample studies, the durability of AHGs was worse than that of PHGs [8–10]. Therefore, we hypothesized that the PM 2.5 effect on their durability was different.…”

Section: Resultsmentioning

confidence: 89%

Association between postoperative fine particulate matter exposure and right ventricle-pulmonary artery conduit patency

Chao

Zhang

et al. 2023

Preprint

View full text Add to dashboard Cite

Background: Ambient air pollution is a leading risk factor for cardiovascular diseases. No study has investigated the association between fine particulate matter (PM2.5) exposure and prognosis of patients undergoing right ventricle-pulmonary (RV-PA) artery conduit surgery. We hypothesized that PM2.5 can lead to stenosis of the conduit by stimulating inflammatory response in the conduit lumen. Methods: From 2013 to 2020, patients with six complicated congenital heart defects and had undergone RV-PA operation in Beijing Fuwai Hospital were selected. Four conduit materials were used: bovine jugular vein graft (BJV), pulmonary homograft (PHG), aortic homograft (AHG), and handmade tri-leaflet expanded polytetrafluoroethylene (ePTFE) conduit. Telephone interviews were used to confirm the patients' postoperative addresses. The monthly averages of PM2.5 concentrations were obtained from the ChinaHighPM2.5 dataset using patients' places of residence. By comparing findings of echocardiography performed prior to patients' return to their residence and during re-examination, we defined the trans-conduit peak velocity increase of ≥1.5 m/s as the study endpoint. Results: 232 patients were included in the study. Logistic analysis identified the female gender to be a protective factor against conduit velocity increase (Odd Ratio (OR) 0.270 (95% confidential interval (CI): 0.094-0.780), P = 0.016). Compared with BJV conduits, homografts (AHGs and PHGs) (0.052 (95% CI: 0.005-0.558), P = 0.015) and ePTFE conduits (0.009 (95% CI: 0.002-0.054), P <0.001) were protective factors. The cumulative monthly PM2.5 concentration (unit 10μg/m3) was a risk factor (1.014 (95% CI: 1.001-1.026), P = 0.028). Winter experience was a risk factor (1.971 (95% CI: 1.021-3.804, P = 0.043). In the subgroup analysis, Spearman correlation analysis identified BJV conduits (r = 0.680, P <0.001), PHGs (r = 0.559, P = 0.020), AHGs (r = 0.745, P = 0.021) had medium-to-high positive correlations between the cumulative PM2.5 concentration and conduit velocity change. For ePTFE, the correlation was weak and not significant (r = 0.222, P = 0.073). Conclusion: Postoperative PM2.5 exposure affects the patency of biologic prosthetic conduits, especially the xenograft. The ePTFE conduit velocity increase is not associated with PM2.5 exposure which is a suitable material for patients living in high pollutant concentration areas.

show abstract

“…Recently there is an increasing number of alternative valved conduits implanted, such as BJVC. In fact, there are centers reporting either the superiority (7) or equivalence (13,8) of BJVC to homografts.…”

Section: Discussionmentioning

confidence: 99%

20-year follow-up and comparison of homografts with bovine jugular vein conduits in children less than 2 years of age

SABATEEN,

NOSAL,

SOJAK

2023

BLL

View full text Add to dashboard Cite

OBJECTIVES: Repair of congenital heart defects involving right ventricular outfl ow tract (RVOT) may require pulmonary valve replacement at time of primary repair or reoperation. This study compares the outcomes of cryopreserved homografts with bovine jugular vein conduits (BJVC) in children < 2 years of age with RVOT reconstruction. METHODS: Retrospective, single-center review of 70 conduits implanted in 63 patients undergoing right ventricle-to-pulmonary artery reconstruction with valved conduit from 2002 to 2022. RESULTS: A total of 70 conduits were implanted in 63 patients, with mean age of 4.5 ± 6.9 months (range 1 day -23.5 months). The following conduits were used; homografts 38 (54.2 %), BJVC 32 (45.8 %). During mean follow-up of 6.2 ± 5.6 years, there were 12 deaths, 24 conduit reoperations, and 25 catheter reinterventions. Overall survival, reoperation-free, and catheter reintervention-free survival at 15 years was 82.7 %, 31.2 %, and 25.7 %, respectively. Multivariate analysis revealed that low patient weight, age < 30 days at repair, ventilation time, and ICU length of stay were associated with increased risk of death. CONCLUSION: The performance of homografts and BJVC is comparable in patients < 2 years of age. Reoperation for conduit failure was not signifi cantly different between the two groups (Tab. 3, Fig. 3, Ref. 16).

show abstract

Long-Term Follow-Up of Right Ventricle to Pulmonary Artery Biologic Valved Conduits Used in Pediatric Congenital Heart Surgery

Cited by 11 publications

References 33 publications

Clinical experience of reoperative right ventricular outflow tract reconstruction with valved conduits: risk factors for conduit failure in long-term follow-up

Clinical experience of reoperative right ventricular outflow tract reconstruction with valved conduits: risk factors for conduit failure in long-term follow-up

Association between postoperative fine particulate matter exposure and right ventricle-pulmonary artery conduit patency

20-year follow-up and comparison of homografts with bovine jugular vein conduits in children less than 2 years of age

Contact Info

Product

Resources

About