Monocusp valve and transannular patch reconstruction of the right ventricular outflow tract

An experimental study

Vincent A. Scavo, Mark Turrentine, Thomas X. Aufiero, Kyung Sun, Robert Binford, Glenn Carlos, John Brown

Research output: Contribution to journalArticle

17 Citations (Scopus)

Abstract

Repair of congenital right ventricular outflow tract obstruction often requires reconstruction with a transannular patch to alleviate pulmonary stenosis. Post repair pulmonary insufficiency with right ventricular dilatation and volume overload may result and lead to acute or progressive right heart failure. The use of a monocusp valve has been proposed as a means to prevent this problem. Fresh pericardium is well known to fail clinically, leading to pulmonary insufficiency limiting mid- and long-term results. In a chronic dog model (147 ± 34 days), three valve types were evaluated: 1) polytetrafluoroethylene (PTFE; n = 9), 2) fresh pericardium (PERI; n = 6), and glutaraldehyde fixed pericardium (GLU; n = 6). Hemodynamics, angiography, and echocardiography were performed at implantation and sacrifice. Gross and microscopic pathology were evaluated. No significant differences were found among the three groups with regard to stenosis as evaluated by echocardiography, measured right ventricular wall thickness, and hemodynamic pressure gradients across the valve. By echocardiography, both PTFE (1 of 9) and GLU (0 of 6) showed less regurgitation than PERI (5 of 6) (p < 0.05). This was confirmed by angiography. PTFE showed less neo-intimal hyperplasia, less thrombus formation, and less calcification than GLU or PERI (p = NS). The PTFE monocusp developed no prohibitive gradients, no early pathologic deterioration, and maintained competence compared with the GLU and PERI groups. Although continued investigation of long-term durability and competence of the PTFE monocusp valve is warranted, both PTFE and GLU values seem to demonstrate less regurgitation than the PERI monocusp valve in an adult dog model of right ventricular outflow tract reconstruction.

Original languageEnglish
JournalASAIO Journal
Volume44
Issue number5
StatePublished - Sep 1998

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Polytetrafluoroethylene
Polytetrafluoroethylenes
Echocardiography
Pericardium
Angiography
Hemodynamics
Mental Competency
Repair
Dogs
Tunica Intima
Ventricular Outflow Obstruction
Lung
Pulmonary Valve Stenosis
Glutaral
Pathology
Pressure gradient
Hyperplasia
Deterioration
Dilatation
Pathologic Constriction

ASJC Scopus subject areas

  • Biophysics
  • Bioengineering

Cite this

Monocusp valve and transannular patch reconstruction of the right ventricular outflow tract : An experimental study. / Scavo, Vincent A.; Turrentine, Mark; Aufiero, Thomas X.; Sun, Kyung; Binford, Robert; Carlos, Glenn; Brown, John.

In: ASAIO Journal, Vol. 44, No. 5, 09.1998.

Research output: Contribution to journalArticle

Scavo, Vincent A. ; Turrentine, Mark ; Aufiero, Thomas X. ; Sun, Kyung ; Binford, Robert ; Carlos, Glenn ; Brown, John. / Monocusp valve and transannular patch reconstruction of the right ventricular outflow tract : An experimental study. In: ASAIO Journal. 1998 ; Vol. 44, No. 5.
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