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Assessment of Untreated Fresh Autologous Pericardium as Material for Construction of Heart Valve: Result at 5 Years

INTRODUCTION: Tetralogy of Fallot requiring transannular repair of the right ventricular outflow tract (RVOT) are exposed to free pulmonary insufficiency and hence inevitable right ventricular dysfunction. This study analyzes the function and structure of untreated autologous pericardium monocusp us...

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Autores principales: Arya, Amitabh, Srivastava, Navneet Kumar, Pande, Shantanu, Tripathi, Shashank, Agarwal, Surendra Kumar, Tewari, Prabhat, Kapoor, Aditya
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Wolters Kluwer - Medknow 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6639893/
https://www.ncbi.nlm.nih.gov/pubmed/31274488
http://dx.doi.org/10.4103/aca.ACA_50_18
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author Arya, Amitabh
Srivastava, Navneet Kumar
Pande, Shantanu
Tripathi, Shashank
Agarwal, Surendra Kumar
Tewari, Prabhat
Kapoor, Aditya
author_facet Arya, Amitabh
Srivastava, Navneet Kumar
Pande, Shantanu
Tripathi, Shashank
Agarwal, Surendra Kumar
Tewari, Prabhat
Kapoor, Aditya
author_sort Arya, Amitabh
collection PubMed
description INTRODUCTION: Tetralogy of Fallot requiring transannular repair of the right ventricular outflow tract (RVOT) are exposed to free pulmonary insufficiency and hence inevitable right ventricular dysfunction. This study analyzes the function and structure of untreated autologous pericardium monocusp used to create a competent pulmonary valve. MATERIALS AND METHODS: This is a retrospective analysis of 52 cases operated between December 2006 and December 2012. Untreated autologous pericardium was used for creating a competent pulmonary valve following a transannular patch. They are followed for functional and structural assessment of the pulmonary valve by echocardiography. Positron emission tomography (PET) with 18 fluorodeoxyglucose was performed in two cases for profiling the pulmonary valve. RESULTS: Median age was 10.5 years (1–38). The follow-up was complete for 42 (80.76%) patients for 3 years and 25 (48.07%) patients for 5 years. The RVOT gradient was 42 mmHg (16–96) in the year of surgery, which reduced to 26 mmHg (10–58) and pulmonary insufficiency that was present in 8.3% of patients in 1(st) year was witnessed in 22.7% in the 5(th) year of follow-up. The monocusp patch was successful in creating a competent valve while maintaining its structure at 3 years; however, it became distorted and retracted at 5 years of follow-up. There was no calcification in any of the patients. PET-computed tomography confirmed the uptake of glucose by monocusp at 1 year of follow-up. CONCLUSION: The untreated autologous pericardium functioned well when it was used to create a competent pulmonary valve at short term and midterm. Although it changed in its structure; there was no calcification at 5 years of follow-up.
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spelling pubmed-66398932019-07-31 Assessment of Untreated Fresh Autologous Pericardium as Material for Construction of Heart Valve: Result at 5 Years Arya, Amitabh Srivastava, Navneet Kumar Pande, Shantanu Tripathi, Shashank Agarwal, Surendra Kumar Tewari, Prabhat Kapoor, Aditya Ann Card Anaesth Original Article INTRODUCTION: Tetralogy of Fallot requiring transannular repair of the right ventricular outflow tract (RVOT) are exposed to free pulmonary insufficiency and hence inevitable right ventricular dysfunction. This study analyzes the function and structure of untreated autologous pericardium monocusp used to create a competent pulmonary valve. MATERIALS AND METHODS: This is a retrospective analysis of 52 cases operated between December 2006 and December 2012. Untreated autologous pericardium was used for creating a competent pulmonary valve following a transannular patch. They are followed for functional and structural assessment of the pulmonary valve by echocardiography. Positron emission tomography (PET) with 18 fluorodeoxyglucose was performed in two cases for profiling the pulmonary valve. RESULTS: Median age was 10.5 years (1–38). The follow-up was complete for 42 (80.76%) patients for 3 years and 25 (48.07%) patients for 5 years. The RVOT gradient was 42 mmHg (16–96) in the year of surgery, which reduced to 26 mmHg (10–58) and pulmonary insufficiency that was present in 8.3% of patients in 1(st) year was witnessed in 22.7% in the 5(th) year of follow-up. The monocusp patch was successful in creating a competent valve while maintaining its structure at 3 years; however, it became distorted and retracted at 5 years of follow-up. There was no calcification in any of the patients. PET-computed tomography confirmed the uptake of glucose by monocusp at 1 year of follow-up. CONCLUSION: The untreated autologous pericardium functioned well when it was used to create a competent pulmonary valve at short term and midterm. Although it changed in its structure; there was no calcification at 5 years of follow-up. Wolters Kluwer - Medknow 2019 /pmc/articles/PMC6639893/ /pubmed/31274488 http://dx.doi.org/10.4103/aca.ACA_50_18 Text en Copyright: © 2019 Annals of Cardiac Anaesthesia http://creativecommons.org/licenses/by-nc-sa/4.0 This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms.
spellingShingle Original Article
Arya, Amitabh
Srivastava, Navneet Kumar
Pande, Shantanu
Tripathi, Shashank
Agarwal, Surendra Kumar
Tewari, Prabhat
Kapoor, Aditya
Assessment of Untreated Fresh Autologous Pericardium as Material for Construction of Heart Valve: Result at 5 Years
title Assessment of Untreated Fresh Autologous Pericardium as Material for Construction of Heart Valve: Result at 5 Years
title_full Assessment of Untreated Fresh Autologous Pericardium as Material for Construction of Heart Valve: Result at 5 Years
title_fullStr Assessment of Untreated Fresh Autologous Pericardium as Material for Construction of Heart Valve: Result at 5 Years
title_full_unstemmed Assessment of Untreated Fresh Autologous Pericardium as Material for Construction of Heart Valve: Result at 5 Years
title_short Assessment of Untreated Fresh Autologous Pericardium as Material for Construction of Heart Valve: Result at 5 Years
title_sort assessment of untreated fresh autologous pericardium as material for construction of heart valve: result at 5 years
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6639893/
https://www.ncbi.nlm.nih.gov/pubmed/31274488
http://dx.doi.org/10.4103/aca.ACA_50_18
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