“…In 10 of the patients, the posterior wall of the RVOT was constructed with a pulmonary fl ap of the left pulmonary artery [Barbero-Marcial 1989], but in accordance with these authors' technical specifi cations, we did not use a monocuspid patch. For the reconstruction of the pulmonary ventricle, we adapted a PBP to the neopulmonary annulus.…”
Earlier reconstruction of the pulmonary valve and the RVOT may preserve ventricular performance for a long period. Nevertheless, the porcine pulmonary prosthesis has shown satisfactory results when it has been used for the reconstruction of different types of RV obstructions.
“…In 10 of the patients, the posterior wall of the RVOT was constructed with a pulmonary fl ap of the left pulmonary artery [Barbero-Marcial 1989], but in accordance with these authors' technical specifi cations, we did not use a monocuspid patch. For the reconstruction of the pulmonary ventricle, we adapted a PBP to the neopulmonary annulus.…”
Earlier reconstruction of the pulmonary valve and the RVOT may preserve ventricular performance for a long period. Nevertheless, the porcine pulmonary prosthesis has shown satisfactory results when it has been used for the reconstruction of different types of RV obstructions.
“…The remodeling of continuity between the right ventricle and the pulmonary artery is usually carried out with the implantation of a synthetic or biological valved conduit, appropriate to the patient's weight and body surface. [1] This model of prostheses, will require its early replacement, in growing patients, to avoid the mismatch and mineralization process, that occurs in practically all pediatric patients The remodeling of the right ventricular outflow tract, eliminating the use of valved conduits, was described by the author [2], using a monocuspid biological prosthesis. Despite the ingenious conception of this technique, there has been an increasing number of reoperations, due to stenosis of the prosthesis employed.…”
Section: Introductionmentioning
confidence: 99%
“…In this 2-month-old patient, the principle of the technique described by the author [2]. The technique consists of the disconnection of the pulmonary artery from the ascending aorta and closure of the aortic wall, with biological patch, avoiding distortion of the truncal valve.…”
We report long-term outcome after one-stage, surgical repair, in a two months-old girl with persistent truncus arteriosus type I, II. The operation was carried out with the remodeling of the right ventricle, using a swine bicuspid pulmonary prosthesis. Twenty-six years later, the patient is in excellent clinical condition, CF I (NYHA), with normal peripheral oxygen saturation. Recent invasive and not invasive imaging show: absence of intracardiac shunt and growing of the right ventricle outlet tract and discrete double lesion of the pulmonary valve. The pulmonary flow directed uniformly for both lungs. In selected cases, the long-term prognosis of patients with persistent truncus arteriosus, undergoing early surgical repair, avoiding the use of valved conduit, makes for an excellent evolution, without new interventions. Endovascular procedures, now well standardized, for the implantation of a pulmonary valve stent, through a catheter, will allow an effective approach, in the presence of late obstructions, in patients who have undergone right ventricular remodeling, without the use of valved conduits.
“…The remodeling of the right ventricular outflow tract, eliminating the use of valved conduits, was described by Barbero-Marcial, using a monocuspid biological prosthesis. Despite the ingenious conception of this technique, there has been an increasing number of reoperations, due to stenosis of the prosthesis employed [1]. Our Group at the Federal University of São Paulo has been using the right ventricular remodeling technique since 1990, using swine valve prostheses (bicuspid prosthesis).…”
We report long-term outcome after one-stage, surgical repair, in a two months- old girl with Persistent Truncus Arteriosus type I, II. The operation was carried out with the remodeling of the right ventricle, using a swine bicuspid pulmonary prosthesis. Twenty-six years later, the patient is in excellent clinical condition, CF I (NYHA), with normal peripheral oxygen saturation. Recent invasive and not invasive imaging show: absence of intracardiac shunt and growing of the right ventricle outlet tract and discrete double lesion of the pulmonary valve. The pulmonary flow directed uniformly for both lungs. In selected cases, the long- term prognosis of patients with truncus arteriosus, undergoing early surgical repair, avoiding the use of valved conduit, makes for an excellent evolution, without new interventions. Endovascular procedures, now well standardized, for the implantation of a pulmonary valve stent, through a catheter, will allow an effective approach, in the presence of late obstructions, in patients who have undergone right ventricular remodeling, without the use of valved conduits.
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