Valved and nonvalved right ventricular-pulmonary arterial extracardiac conduits. An experimental comparison

A. C. Fiore, P. S. Peigh, R. J. Robison, M. D. Glant, H. King, John Brown

Research output: Contribution to journalArticle

17 Citations (Scopus)

Abstract

Extracardiac conduits are essential in operations for congenital discontinuity between the right ventricle and the pulmonary artery. The disturbing degree of obstruction reported in clinical series of extracardiac conduits containing porcine valves has been attributed in part to early valve deterioration and the development of a thick neointimal lining within the Dacron graft. This study compares the hemodynamic differences and the thickness of the neointimal lining in right ventricular extracardiac conduits with and without a porcine valve. Woven Dacron conduits (16 mm) were implanted in 15 adult mongrel dogs, and then the proximal pulmonary artery was occluded with Dacron tape. In six dogs, the extracardiac conduit contained a porcine valve, whereas in the other nine it did not. Cardiac output, transconduit gradient, and resistance were measured at operation and 6 months postoperatively in both groups. No hemodynamic differences were noted. After 1 year, the thickness of the neointimal lining was threefold greater in valved conduits (1.370 ± 313.1 μ versus 367 ± 28.07 μ, p <0.005). The neointima along the Dacron graft was thickest proximal and distal to the porcine valve. The luminal peel in valved conduits contained fenestrations and intimal flaps, similar to those observed clinically. In our model, a porcine valve in a right ventricular extracardiac conduit is associated with intimal hyperplasia and seen in nonvalved conduits. If the pulmonary vascular resistance is normal, then the absence of a valve within the conduit does not significantly change hemodynamics and may warrant clinical application to prevent late conduit obstruction.

Original languageEnglish (US)
Pages (from-to)490-497
Number of pages8
JournalJournal of Thoracic and Cardiovascular Surgery
Volume86
Issue number4
StatePublished - 1983
Externally publishedYes

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Polyethylene Terephthalates
Swine
Lung
Tunica Intima
Hemodynamics
Pulmonary Artery
Dogs
Transplants
Neointima
Cardiac Output
Vascular Resistance
Heart Ventricles
Hyperplasia

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Surgery

Cite this

Valved and nonvalved right ventricular-pulmonary arterial extracardiac conduits. An experimental comparison. / Fiore, A. C.; Peigh, P. S.; Robison, R. J.; Glant, M. D.; King, H.; Brown, John.

In: Journal of Thoracic and Cardiovascular Surgery, Vol. 86, No. 4, 1983, p. 490-497.

Research output: Contribution to journalArticle

Fiore, A. C. ; Peigh, P. S. ; Robison, R. J. ; Glant, M. D. ; King, H. ; Brown, John. / Valved and nonvalved right ventricular-pulmonary arterial extracardiac conduits. An experimental comparison. In: Journal of Thoracic and Cardiovascular Surgery. 1983 ; Vol. 86, No. 4. pp. 490-497.
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