TY - JOUR AU - Maluf, Miguel A. AU - Carvalho, Antonio C. C. AU - Carvalho, Werther B. PY - 2011/02/23 Y2 - 2024/03/28 TI - Use of Right Ventricular Remodeling Surgery with a Porcine Pulmonary Prosthesis for Congenital Heart Disease JF - The Heart Surgery Forum JA - HSF VL - 14 IS - 1 SE - DO - 10.1532/HSF98.20101041 UR - https://journal.hsforum.com/index.php/HSF/article/view/1158 SP - E40-E50 AB - <p><b>Background:</b> The reconstruction of the right ventricular outflow tract (RVOT) in congenital heart disease has attracted the interest of cardiac surgeons determined to alleviate the anatomic obstruction and restore RV function.</p><p><b>Methods:</b> From June 1991 to September 2008, 203 consecutive patients (mean, 3.0 years; range, 2 months to 35 years) underwent operations. These patients were classified into 5 groups: group 1, tetralogy of Fallot with pulmonary hypoplasia (144 cases, 70.9%); group 2, pulmonary atresia (PA) with ventricular septal defect (VSD) (32 cases, 15.7%); group 3, truncus arteriosus (12 cases, 5.9%); group 4, transposition of the great arteries with left ventricular outflow tract obstructions (8 cases, 3.9%); and group 5, PA with intact ventricular septum (7 cases, 3.4%). Remodeling surgery of the RV consisted of patch closure of the VSD (n = 176), tricuspid valvoplasty repair (n = 25), infundibulum muscle resection, and reconstruction of the RVOT (all patients). The Lecompte procedure was performed in 8 patients in group 4, and the one and a half ventricle technique was performed in 7 patients in group 5.</p><p><b>Results:</b> There were 21 hospital deaths (10.3%); 180 patients (88.6%) survived. Patients were followed up from 4 to 206 months (mean, 98.0 months). Sixteen patients (8.8%) underwent reoperation for prosthesis dysfunction, with 2 inhospital deaths (12.5%). The rest of the patients (164, 80.7%) remain free of reoperation.</p><p><b>Conclusion:</b> 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.</p> ER -