Composite and plain tubular synthetic graft conduits in right ventricle-pulmonary artery position: Fate in growing lambs J.Ernesto Molina, MD, PhD, Jesse.

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Composite and plain tubular synthetic graft conduits in right ventricle-pulmonary artery position: Fate in growing lambs J.Ernesto Molina, MD, PhD, Jesse E. Edwards, MD, Richard W. Bianco, BA, Rosemarie W. Clack, BS, Gregory Lang, BS, Jorge R. Molina, BA The Journal of Thoracic and Cardiovascular Surgery Volume 110, Issue 2, Pages 427-435 (August 1995) DOI: 10.1016/S0022-5223(95)70239-3 Copyright © 1995 Mosby, Inc. Terms and Conditions

Fig. 1 Exposure of pulmonary trunk via left thoracotomy. Descending thoracic aorta is cannulated for arterial perfusion and right atrium for venous drainage. Interrupted line at bifurcation of pulmonary arteries (marked by arrows) shows distal line of resection. Proximal interrupted lines show two levels depending on whether native pulmonary valve was excised (for use of composite conduits) or left intact (tubular, plain conduits). Ao, Aorta; PA, pulmonary artery. The Journal of Thoracic and Cardiovascular Surgery 1995 110, 427-435DOI: (10.1016/S0022-5223(95)70239-3) Copyright © 1995 Mosby, Inc. Terms and Conditions

Fig. 2 Implantation of plain tubular conduit of Dacron material anastomosed from just above native pulmonary valve to bifurcation of pulmonary arteries. Ao, Aorta. The Journal of Thoracic and Cardiovascular Surgery 1995 110, 427-435DOI: (10.1016/S0022-5223(95)70239-3) Copyright © 1995 Mosby, Inc. Terms and Conditions

Fig. 3 Rate of growth of lambs followed up from age 4 weeks to 24 months. Wt., weight. The Journal of Thoracic and Cardiovascular Surgery 1995 110, 427-435DOI: (10.1016/S0022-5223(95)70239-3) Copyright © 1995 Mosby, Inc. Terms and Conditions

Fig. 4 Pressure gradients across conduit. Measurements taken in right ventricular chamber and in distal pulmonary arteries. Notice that PTFE (Gore-Tex brand) and allograft conduits had almost similar evolution. Knitted, Dacron fabric 2500 pore preclotted; Woven, Dacron fabric 50 porosity preclotted; Knitt. Coll., knitted grafts with collagen coating; Ochsner-Pre, interlock 500 or 800 preclotted; Gore-Tex, 35 μm; Allograft, cryopreserved valved lamb pulmonary allograft (see text). The Journal of Thoracic and Cardiovascular Surgery 1995 110, 427-435DOI: (10.1016/S0022-5223(95)70239-3) Copyright © 1995 Mosby, Inc. Terms and Conditions

Fig. 5 Comparison of composite valved conduits of woven Dacron fabric with pericardial tissue valve built in (Ionescu-Shiley valve) versus PTFE conduit with St. Jude Medical mechanical valve prosthesis and cryopreserved valved lamb allograft (see text). Severe obstruction of Dacron fabric woven conduit occurred rapidly. No lambs survived after 12 months. The Journal of Thoracic and Cardiovascular Surgery 1995 110, 427-435DOI: (10.1016/S0022-5223(95)70239-3) Copyright © 1995 Mosby, Inc. Terms and Conditions