TY - JOUR
T1 - The Pericardial Membrane Pulmonary Monocusp
T2 - Surgical Technique and Early Results
AU - Roughneen, Patrick T.
AU - DeLeon, Serafin Y.
AU - Parvathaneni, Sirish
AU - Cetta, Frank
AU - Eidem, Benjamin
AU - Vitullo, Dolores A.
PY - 1985/9
Y1 - 1985/9
N2 - Abstract Long‐term pulmonary insufficiency resulting from simple transannular patching of the right ventricle outflow tract will ultimately lead to deterioration in right ventricular function. Previously, monocusps constructed from xenografts, homografts, fascia lata, and autologous pulmonary artery wall have been utilized to minimize pulmonary regurgitation and its deleterious effect on right ventricular function. However, these tend to degenerate in the long term, necessitating reoperation. To circumvent this problem we have used a monocusp constructed from 0·1−mm polytetrafluorethylene (PTFE, pericardial membrane) clinically demonstrated to be resistant to issue ingrowth and degeneration. Seven children (5 tetralogy of Fallot, 2 pulmonary stenosis) who required division of a small pulmonary an‐nulus underwent monocusp construction with 0.1‐mm PTFE. Three patients had previous corrective surgery. One of these patients had a bovine pericardial monocusp placed 8 years previously, which degenerated. Of the remaining two patients, one had a pulmonary valvo‐tomy as a neonate, the other repair of tetralogy of Fallot with a transannular patch. At a mean (± standard deviation) follow up to 17 ± 5·8 months all patients are alive and are New York Heart Association (NYHA) Class I. Echocardiography demonstrates mild pulmonary insufficiency (PI) in 2 patients, mild to moderate PI in 4, and moderate to severe PI in 1. The presence of a pericardial membrane monocusp in the pulmonary position may, in the long term, prevent the deleterious effects of transannular patching on right ventricular dysfunction and be more resistant to degenerative changes characteristic of monocusps constructed of native pericardium or allogeneic tissue.
AB - Abstract Long‐term pulmonary insufficiency resulting from simple transannular patching of the right ventricle outflow tract will ultimately lead to deterioration in right ventricular function. Previously, monocusps constructed from xenografts, homografts, fascia lata, and autologous pulmonary artery wall have been utilized to minimize pulmonary regurgitation and its deleterious effect on right ventricular function. However, these tend to degenerate in the long term, necessitating reoperation. To circumvent this problem we have used a monocusp constructed from 0·1−mm polytetrafluorethylene (PTFE, pericardial membrane) clinically demonstrated to be resistant to issue ingrowth and degeneration. Seven children (5 tetralogy of Fallot, 2 pulmonary stenosis) who required division of a small pulmonary an‐nulus underwent monocusp construction with 0.1‐mm PTFE. Three patients had previous corrective surgery. One of these patients had a bovine pericardial monocusp placed 8 years previously, which degenerated. Of the remaining two patients, one had a pulmonary valvo‐tomy as a neonate, the other repair of tetralogy of Fallot with a transannular patch. At a mean (± standard deviation) follow up to 17 ± 5·8 months all patients are alive and are New York Heart Association (NYHA) Class I. Echocardiography demonstrates mild pulmonary insufficiency (PI) in 2 patients, mild to moderate PI in 4, and moderate to severe PI in 1. The presence of a pericardial membrane monocusp in the pulmonary position may, in the long term, prevent the deleterious effects of transannular patching on right ventricular dysfunction and be more resistant to degenerative changes characteristic of monocusps constructed of native pericardium or allogeneic tissue.
UR - http://www.scopus.com/inward/record.url?scp=85005397705&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85005397705&partnerID=8YFLogxK
U2 - 10.1111/j.1540-8175.1985.tb01309.x
DO - 10.1111/j.1540-8175.1985.tb01309.x
M3 - Article
AN - SCOPUS:85005397705
SN - 0742-2822
VL - 2
SP - 370
EP - 374
JO - Echocardiography
JF - Echocardiography
IS - 5
ER -