Porcine valved pulmonary conduit with potential for biointegration. A new graft option in the reconstruction of the right ventricle outflow. Early results

  • Dr Glaucio Furlanetto, Instituto Furlanetto, Brazil
  • Dr Sandra Henriques, Instituto Furlanetto, Brazil
  • Dr Patricia Medeiros, Instituto Furlanetto, Brazil
  • Dr Grace Bichara, Instituto Furlanetto, Brazil
  • Dr Lilian Lopes, Instituto Furlanetto, Brazil
  • Dr Salvador Cristovão, Instituto Furlanetto, Brazil
  • Dr Mario Olmos, Instituto Furlanetto, Brazil
  • Dr Beatriz Furlanetto, Instituto Furlanetto, Brazil

    • OBJECTIVE: To date, there is no suitable valved conduit for small children with anomaly of the right ventricle outflow. Experimental study accomplished in sheep with the L-Hydro porcine valved pulmonary conduit (PVPC) revealed long term great results with biointegration and growth besides the valvular leaflets. The L-Hydro is an alternative method of non-aldehyde tissue preservation and have been attempted to encourage implants to re-cellularize with host endothelial cells which allows potential regeneration and growth of the valvular tissue, transforming it in a living structure. The purpose of this investigation is to analyze the immediate results of PVPC in children with right ventricle outflow anomalies (RVA).

    METHODS: Between October 2006 and December 2008, 25 children with RVA undergoing PVPC implants (15 Tetralogy of Fallot (TF); 3 Pulmonary Atresia with Ventricular Septal Defect; 2 Double Outlet Right Ventricle; 1 reoperation of TF; 2 Truncus Arteriosus (TAC); 1 reoperação TAC); 14 was male and 16 had age below 1 year. The implants were done with bypass circulation at 27° C, normoflow and use of cardioplegic solution with blood. The size of the grafts varied from 11 mm to 19 mm.

    RESULTS: There was 1 surgical death (4%). A color ecodopplercardiografic control done at immediate surgical period showed moderate valvar insuficience in 2 children and important in 1 child.

    CONCLUSION: The use of porcine valved pulmonary conduit L-Hydro showed a good immediate result and a late follow-up is necessary to evaluate the advantages and disadvantages on the other substitutes available for the pulmonary valve.