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Early results of neopulmonary valve creation technique using right atrial appendage tissue
Author(s) -
Onan Ismihan S.,
Ergün Servet,
Özturk Erkut,
Çelik Ekin C.,
Ayyıldız Pelin,
Onan Burak
Publication year - 2020
Publication title -
journal of cardiac surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.428
H-Index - 58
eISSN - 1540-8191
pISSN - 0886-0440
DOI - 10.1111/jocs.14860
Subject(s) - medicine , ventricle , tetralogy of fallot , ventricular outflow tract , cardiology , cardiopulmonary bypass , pulmonary valve , intensive care unit , pulmonary atresia , aortic valve , surgery , heart disease
Abstract Introduction Various valve repair techniques have been described for prevention of pulmonary insufficiency (PI) during right ventricular outflow tract (RVOT) reconstruction with transannular patch. Herein, we present the early results of an alternative technique of neopulmonary valve reconstruction using right atrial appendage (RAA) tissue. Methods Between October 2019 and December 2019, 12 patients with tetralogy of fallot (TOF) (n = 10), TOF‐absent pulmonary valve (n = 1) and intact ventricular septum‐pulmonary atresia (n = 1) underwent RVOT reconstruction with neopulmonary valve that was created using RAA tissue. Median age and weight of patients were 9.9 months (5 months‐14 years) and 9.8 kg (6.2‐47), respectively. Results No mortality or major events developed. Postoperative echocardiography revealed none/trace PI in 11 patients and mild PI in 1 patient. Median right ventricle/left ventricle ratio was 0.46 (0.35‐0.65) and RVOT gradient was 20 mm Hg (0‐30). Median cardiopulmonary bypass and aortic clamping times were 121 minutes (81‐178) and 94 minutes (59‐138), respectively. Operative times revealed statistically significant learning curve pattern in terms of cardiopulmonary bypass ( r 2 = .568; P = .005) and aortic clamping times ( r 2 = .635; P = .002). Median ventilation time, intensive care unit stay, and the length of hospital stay were 6 hours (2‐48), 1 days (1‐5), and 7 days (4‐10), respectively. Longer perfusion time was not correlated with postoperative times. At median 6 months, echocardiography showed none/trivial PI in 11 patients and mild PI in one patient. Conclusion Early results showed that neopulmonary valve reconstruction using the RAA tissue may provide a reasonable alternative for RVOT reconstruction with transannular patch. But long‐term results are needed.