Abstract
Artificial pulmonary trunk is required for complete repair of the wide spectrum of congenital heart defects. Till nowadays, the “ideal conduit” remains one of unsolved issues of congenital heart surgery and a lot of patients require late reoperation mostly due to conduit deterioration and stenosis.
This review describes a range of available conduits, implantation – associated complication, reasons of their dysfunction and indication for reoperation in connection with leading hemodynamic problem (stenosis/insufficiency). Paper represents immediate and long-term results of stenosis and (or) insufficiency repair.
References
- Klinner W., Zenker R. Experience with correction of Fallot's tetralogy in 178 cases. Surgery. 1963; 57 (5): 353–7.
- Burakovski V.I., Chekanov V.S., Krasikov L.I. Replacement of pulmonary trunc in tetralogy of Fallot. Thoracic Surgery. 1975; 5: 3–7 (in Russ.).
- Schlichter A., Kreutzer C., de Cassia Mayorquim R., Simon J., Román M., Vazquez H. et al. Five- to fifteenyear follow-up of fresh autologous pericardial valved conduits. J. Thorac. Cardiovasc. Surg. 2000; 119: 868–79. DOI: 10.1016/S0022-5223(00)70081-X
- Ando M., Imai Y., Takanashi Y., Hoshino S., Seo K., Terada M. Fate of trileaflet equine pericardial extracardiac conduit used for the correction of anomalies having pulmonic ventricle-pulmonary arterial discontinuity. Ann. Thorac. Surg. 1997; 64 (1): 154–8. DOI: 10.1016/s0003-4975(97)00278-6
- Podzolkov V.P., Yurlov I.A., Kostava V.T., Kovalev D.V., Dekhkanov O.H., Britikov D.V. et al. Analysis of the results of the use of bioconduits as an artificial pulmonary artery. The Bulletin of Bakoulev Center. Cardiovascular Diseases. 2003; 4 (11): 17 (in Russ.).
- Podzolkov V.P., Kokshenev I.V., Yurlov I.A., Samsonov V.B., Kovalev D.V., Danilov T.Yu. et al. Experience reoperations after implantation of artificial pulmonary artery trunk with radical correction of congenital heart defects. Children's Heart and Vessel Diseases. 2014; 2: 22–9 (in Russ.).
- Gallo R., Kumar N., Prabhakar J., Al-Halees Z., Carlos M.G. Accelerated degeneration of aortic homograft in an infant. J. Thorac. Cardiovasc. Surg. 1994; 107: 1161–2. DOI: 10.1016/S0022-5223(94)70402-3
- Meldrum-Hanna W., Cartmill T., Johnson D., Celermajer J., Hawker R. Late results of right ventricular outflow tract reconstruction with Bjork-Sheily valved conduits. Brit. Heart J. 1986; 55 (4): 371–5. DOI: 10.1136/hrt.55.4.371
- Ilbawi M.N., Lockhart C.G., Idriss F.S., Deleon S.Y., Muster A.J., Duffy C.E. et al. Experience with St. Jude Medical valve prosthesis in children. A word of caution regarding right-sided placement. J. Thorac. Cardiovasc. Surg. 1987; 93 (1): 73–9.
- Molina J.E. Use of polytetrafluoroehylene (Gore-Tex) grafts for the construction of right ventricle-pulmonary artery conduits. Ann. Thorac. Surg. 1999; 67: 760–4. DOI: 10.1016/s0003-4975(10)60080-x
- Ross D.N. Application of homograft in clinical surgery. J. Cardiovasc. Surg. 1987; 2 (1): 175–82.
- Podzolkov V.P., Alekyan B.G., Kokshenev I.V., Cheban V.N. Reoperations after the correction of the congenital heart diseases. Moscow; 2013 (in Russ.).
- Kirklin J., Barratt-Boyes B. Cardiac surgery. New-YorkChicherster-Brislans: A Wiley Med. Publ.; 2013.
- Albert J., Bishop D., Fullerton D., Campbell D., Clarke D. Conduit reconstruction of the right ventricular outflow tract: lesion learned in a twelve-year experience. J. Thorac. Cardiovasc. Surg. 1993; 106: 228–36.
- Zelenikin M.A., Volkov S.S., Narmaniya I.T., Britikov D.V. The results of the reconstruction of outflow tract of venosus ventricle with pulmonary allograft in children. Part I. Immediate results. The Bulletin of Bakoulev Center. Cardiovascular Diseases. 2018; 19 (5): 663–7 (in Russ.). DOI: 10.24022/1810-0694-2018-19-5-663-667
-
Bove T., Demanet H., Wauthy P., Goldstein J., Dessy H., Viar P.T. et al. Early results of valved bovine jugular vein conduit versus bicuspid homograft for rught ventricular outflow tract reconstruction. Ann. Thorac. Surg.2002; 74: 536–41. DOI: 10.1016/S0003-4975(02)03728-1
- Boething D., Thies W.R., Hecker H., Breymann Th. Mid term course after pediatric right ventricular outflow tract reconstruction: a comparison of homografts, porcine xenografts and Contegras. Eur. J. Cardiothorac. Surg. 2005; 27 (1): 58–66. DOI: 10.1016/j.ejcts.2004.09.009
- Podzolkov V.P., Gadzhiev A.A., Barchukov A.Yu. et al. Surgical approaches in correction of different types disfunction of conduits, which were implanted for the complex congenital heart diseases. Russian Journal of Thoracic and Cardiovascular Surgery. 1997; 5: 19–23 (in Russ.).
- Agarwal K.C., Edwards W.D., Feldt R.H., Danielson G.K., Puga F.J., McGoon D.C. Clinicopathological correlates of obstructed right sided porcine-valved extracardiac conduits. J. Thorac. Cardiovasc. Surg.1981; 81: 591–601.
- Jonas R., Freed M., Mayer J., Castaneda A. Long term follow-up of patients with synthetic right heart conduits. Circulation. 1985; 72: 77–83.
- Askovich B., Hawkins J., Sower C., Minich L., Tani L., Stoddard G. et al. Right ventricle-to-pulmonary artery conduit longevity: is it related to allograft size? Ann. Thorac. Surg.2007; 84: 907–12. DOI: 10.1016/j.athoracsur. 2007.04.104
- Brown J., Ruzmetov M., Rodefeld M., Vijay P., Turrentine M. Right ventricular outflow tract reconstruction with an allograft conduit in non-Ross patients: risk factors for allograft dysfunction and failure. Ann. Thorac. Surg. 2005; 80: 655–64. DOI: 10.1016/j.athoracsur.2005.02.053
- Rodefeld M., Ruzmetov M., Turrentine M., Brown J. Reoperative right ventricular outflow tract conduit reconstruction: risk analyses at follow up. J. Heart Valve Dis. 2008; 17: 119–26.
- Stark J., Pacifico A.D. Reoperations in patients with extracardiac valved conduits. In: Reoperations in cardiac surgery. London: Springer-Varlag; 1989. DOI: 10.1007/978-1-4471-1688-2_20
- Yong M.S., Yim D., d'Udekem Y., Brizard C.P., Robertson T., Galati J.C. et al. Medium-term outcomes of bovine jugular vein graft and homograft conduits in children. ANZ J. Surg. 2015; 85 (5): 381–5. DOI: 10.1111/ans.13018
- Ong K., Boone R., Gao M., Carere R., Webb J., Kiess M. et al. Right ventricle to pulmonary artery conduit reoperations in patients with tetralogy of Fallot or pulmonary atresia associated with ventricular septal defect. J. Am. Cardiol. 2013; 111 (11): 1638–43. DOI: 10.1016/j.amjcard.2013.01.337
- Danilov T.Yu. Disfunction of right ventricle after radical correction of the congenital heart diseases with the obstruction of the pulmonary blood flow: results of development and indications for replacement of the pulmonary artery. Russian Journal of Thoracic and Cardiovascular Surgery. 2008; 2: 61–7 (in Russ.).
- Therrien J., Siu S.C., McLaughlin P.R., Liu P.P., Williams W.G., Webb G.D. Pulmonary valve replacement in adults after repair of tetralogy of Fallot: are we operating too late? J. Am. Coll. Cardiol. 2000; 36: 1670–5. DOI: 10.1016/s1062-1458(01)00281-1
- Ruzmetov M., Shah J., Geiss D., Fortuna R. Decellularized versus standard cryopreserved valve allografts for right ventricular outflow tract reconstruction: A singleinstitution comparison. J. Thorac. Cardiovasc. Surg. 2012; 3: 543–9. DOI: 10.1016/j.jtcvs.2011.12.032
- Li J., Luo S., Liu F., An Q. Systolic function of right ventricular outflow tract is a better predictor to exercise performance after pulmonary valve replacement in tetralogy of Fallot. Pediatr. Cardiol. 2017; 38 (8): 1556–61. DOI: 10.1007/s00246-017-1695-5
- Alvarez-Fuente M., Garrido-Lestache E., FernandezPineda L., Romera B., Sánchez I., Centella T. et al. Timing of PVR: How much can the right ventricle dilate before it looses its remodeling potential? Circulation. 2017; 31; 136 (18): 1703–13. DOI: 10.1007/s00246-015-1320-4
- Shinkawa T., Chipman C., Bozzay T., Tang X., Gossett J.M., Imamura M. Outcome of right ventricle to pulmonary artery conduit for biventricular repair. Ann. Thorac. Surg.2015; 99 (4): 1357–66. DOI: 10.1016/j.athoracsur.2014.07.095
- Kirklin J.W., Barratt-Boyes B.G. Cardiac surgery. N.Y.: Churchill Livingstone; 2004.
- Bermudez Ch.A., Dearani J.A., Puga F.J., Schaff H.V., Warnes C.A., O'Leary P.W. et al. Late results of the peel operation for replacement of failing extracardiac conduits. Ann. Thorac. Surg.2004; 77: 881–8. DOI: 10.1016/j.athoracsur.2003.08.029
- Podzolkov V.P., Cheban V.N., Gadzhiev A.A., Evteev Yu.V., Bondarev Yu.I. Reoperations after the correction of the congenital heart diseases. Russian Journal of Thoracic and Cardiovascular Surgery. 1996; 3: 35–41 (in Russ.).
- Podzolkov V.P., Barchukov A.Yu., Cheban V.N., Yurlov I.A., Kokshenev I.V., Pursanov M.G. et al. Surgical tactics in disfunction of conduits, which were implanted to patients with the congenital heart diseases. Russian Journal of Thoracic and Cardiovascular Surgery. 2000; 4: 4–9 (in Russ.).
- Oechslin E.N., Harrison D.A., Harris L., Downar E., WebbG.D., Siu S.S. et al. Reoperation in adults with repair of tetralogy of Fallot: indications and outcomes. J. Thorac. Cardiovasc. Surg. 1999; 118: 245–51. DOI: 10.1016/s0022-5223(99)70214-x
- PodzolkovV.P., Yurlov I.A., Danilov T.Yu., Gadzhiev A.A., Hassan Ali., Kovalev D.V., et al. Prosthetics of the pulmonary artery valve in the long terms after radical correction of congenital heart defects with obstruction of pulmonary blood flow. Russian Journal of Thoracic and Cardiovascular Surgery. 2008; 4: 4–11 (in Russ).
- De Ruijter F.H., Weenink I., Hitchcook F.J., Meijboom E.J., Bennink G.B. Right ventricular disfunction and pulmonary valve replacement after correction of tetralogy of Fallot. Ann. Thorac. Surg.2002; 73: 1794–800. DOI: 10.1016/s0003-4975(02)03586-5
- Hazekamp M.G., Kurvers M.M., Schoof P.H., Vliegen H.W., Mulder B.M., Roest A.A. et al. Pulmonary valve insertion late after repair of tetralogy of Fallot. Eur. J. Cardiothorac. Surg. 2001; 19: 667–70. DOI: 10.1016/s1010-7940(01)00656-x
- Geva T., Gauvreau K., Powell A.J., Cecchin F., Rhodes J., Geva J. et al. Randomized trial of pulmonary valve replacement with and without right ventricular remodeling surgery. Circulation. 2010; 14; 122 (11): 201–8. DOI: 10.1161/CIRCULATIONAHA.110.951178
- Danilov T.Yu., Mamadshoev B.D. Surgical treatment of right ventricle-pulmonary artery conduit obstruction. The Bulletin of Bakoulev Center. Cardiovascular Diseases. 2016; 17 (1): 4–13 (in Russ.).
- Danielson G., Downing T., Schaff H., Puga F., DiDonato R., Ritter D. Replacement of obstructed extracardiac conduits with autogenous tissue reconstruction. J. Thorac. Cardiovasc. Surg. 1987; 93: 555–9.
- Mohammadi S., Belli E., Martinovic I., Houyel L., Capderou A., Petit J. et al. Surgery for right ventricle to pulmonary artery conduit obstruction: risk factors for further reoperation. Eur. J. Cardiothorac. Surg. 2005; 28: 217–22. DOI: 10.1016/j.ejcts.2005.04.014
- Zachariah J., Pigula F., Mayer J., McElhinney D. Right ventricular to pulmonary artery conduit augmentation compared with replacement in young children. Ann. Thorac. Surg. 2009; 88: 574–80. DOI: 10.1016/j.athoracsur. 2009.04.103
- Danilov T.Yu. Replacement of the pulmonary artery as a prevention method and surgical treatment of a disfunction of right ventricle in the long-term after radical correction of the congenital heart diseases. Children's Heart and Vascular Diseases. 2005; 1: 3–7 (in Russ.).
- Bonhoeffer P., Boudjemline Y., Qureshi S.A. Percutaneous insertion of the pulmonary valve. J. Am. Coll. Cardiol. 2002; 39: 1664–9. DOI: 10.1016/s1062-1458(02)00839-5
- Armstrong A.K., Balzer D.T., Cabalka A.K., Gray R.G., Javois A.J., Moore J.W. One-year follow-up of the Melody transcatheter pulmonary valve multicenter postapproval study. JACC Cardiovasc. Interv. 2014; 7 (11): 1254–62. DOI: 10.1016/j.jcin.2014.08.002
- Kostolny M., Tsang V., Nordmeyer J., Doorn C.V., Frigiola A., Khambadkone S. et al. Rescue surgery following percutaneous pulmonary valve implantation. Eur. J. Cardiothorac. Surg.2008; 33 (4): 607–12. DOI: 10.1016/j.ejcts.2007.12.034
- Homann M., Haehnel J.C., Mendler N., Paek S.U., Holper K., Meisner H. et al. Reconstruction of the RVOT with valved biological conduits: 25 years experience with allografts and xenografts. Eur. J. Cardiothorac. Surg. 2000; 17: 624–30. DOI: 10.1016/s1010-7940(00)00414-0
- Bielefeld M., Bishop D., Campbell D., Mitchell M., Grover F., Clarke D. Reoperative homograft right ventricular outflow tract reconstruction. Ann. Thorac. Surg. 2001; 2: 482–8. DOI: 10.1016/s0003-4975(00)02521-2
- Stark J., Bull C., Stajevic M., Jothi M., Elliott M., de Leval M. Fate of subpulmonary homograft conduits: determinants of late homograft failure. J. Thorac. Cardiovasc. Surg.1998; 115: 506–16. DOI: 10.1016/s0022-5223 (98)70312-5
- Tweddell J., Pelech A., Frommelt P., Mussatto K., Wyman J., Fedderly R. et al. Factors affecting longevity of homograft valves used in right ventricular outflow tract reconstruction for congenital heart disease. Circulation. 2000; 102: 130–5. DOI: 10.1161/01.cir.102.suppl_3.iii-130
- Dearani J., Danielson G., Puga F., Schaff H., Warnes C., Driscoll D. et al. Late follow-up of 1095 patients undergoing operation for complex congenital heart disease utilizing right ventricle to pulmonary artery conduits. Ann. Thorac. Surg. 2003; 75 (2): 399–411. DOI: 10.1016/S0003-4975(02)04547-2
-
Bertels R.A., Dalinghaus M., Witsenburg M., Nijveld A., Bogers Ad J.C., Meijboom F. et al. Results of balloon dilatation of stenotic homografts in pulmonary position in children and young adults. Cardiol. Young. 2012; 22 (5): 589–95. DOI: 10.1017/s1047951112000157
- Hainstock M.R., Marshall A.C., Lock J.E., McElhinney D.B. Angioplasty of obstructed homograft conduits in the right ventricular outflow tract with ultra-noncompliant balloons: assessment of therapeutic efficacy and conduit tears. J. Circ. Cardiovasc. Interv. 2013; 6 (6): 671–9. DOI: 10.1161/circinterventions.112.000073
- Jeong H.-I., Song J., Choi E.Y., Kim S.H., Huh J., Kang I. et al. How long can the next intervention be delayed after balloon dilatation of homograft in the pulmonary position? Korean Circ. J. 2017; 47 (5): 786–93. DOI: 10.4070/kcj.2017.0033
- Cabalka A.K., Hellenbrand W.E., Eicken A., Kreutzer J., Gray R.G., Bergersen L. et al. Relationships among conduit type, pre-stenting, and outcomes in patients undergoing transcatheter pulmonary valve replacement in the prospective North American and European Melody valve trials. JACC. Cardiovasc. Interv. 2017; 10 (17): 1746–59. DOI: 10.1016/j.jcin.2017.05.022
About the authors
Asan P. Zhumanov, Cardiovascular Surgeon, orcid.org/0000-0001-9850-1687