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Fate of Trileaflet Equine Pericardial Extracardiac Conduit Used for the Correction of Anomalies Having Pulmonic Ventricle–Pulmonary Arterial Discontinuity 

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Presentation on theme: "Fate of Trileaflet Equine Pericardial Extracardiac Conduit Used for the Correction of Anomalies Having Pulmonic Ventricle–Pulmonary Arterial Discontinuity "— Presentation transcript:

1 Fate of Trileaflet Equine Pericardial Extracardiac Conduit Used for the Correction of Anomalies Having Pulmonic Ventricle–Pulmonary Arterial Discontinuity  Makoto Ando, Yasuharu Imai, Yoshinori Takanashi, Shuichi Hoshino, Kazuhiro Seo, Masatsugu Terada  The Annals of Thoracic Surgery  Volume 64, Issue 1, Pages (July 1997) DOI: /S (97)

2 Fig. 1 Pulmonary insufficiency detected on follow-up echocardiography.
The Annals of Thoracic Surgery  , DOI: ( /S (97) )

3 Fig. 2 (A) Time-related changes of maximum pressure gradient at conduit portion in 63 patients on echocardiographic investigation. The mean value in each period is listed below. Comparative analysis with the data obtained within 3 months in each individual yields the p value. (B) Time-related changes of pressure gradient across the conduit on cardiac catheterization in 31 patients (representing 21.7% of all cases). The Annals of Thoracic Surgery  , DOI: ( /S (97) )

4 Fig. 3 Right ventriculograms in 15 patients who had pressure gradient across the conduit of more than 40 mm Hg. (A) Stenosis occurred predominantly at the valve attachment site (arrow) with minor contribution of sternal compression (n = 7). Although the portion adherent to the sternum seemed widely patent, turbulent flow occurring at this site may induce the injury at the subvalvular portion and thus contribute to the degeneration of the valve structure. (B) The compressive effect of the sternum superimposes on the adjacent sclerotic valve (arrows), thus multiplying the obstruction of the lumen (n = 6). (C) Bony thorax tightly compresses the conduit structure (arrows) although the valve maintained apparent pliability (n = 2). The Annals of Thoracic Surgery  , DOI: ( /S (97) )

5 Fig. 4 Representative right ventriculogram in patients with pulmonary atresia with ventricular septal defect undergoing direct approximation of the pulmonary trunk to the right ventriculotomy at reoperation for obstructed extracardiac conduit. (A) Before reoperation. (B) After reoperation. The floor of the outflow is directed toward the posterosuperior direction by the effect of retraction by the approximated pulmonary artery (arrows), allowing a generous-sized outflow tract to be reconstructed. The Annals of Thoracic Surgery  , DOI: ( /S (97) )

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