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Failure of the Hemashield extension in right ventricle-to-pulmonary artery conduits.

Publication ,  Journal Article
Kobayashi, J; Backer, CL; Zales, VR; Crawford, SE; Muster, AJ; Mavroudis, C
Published in: Ann Thorac Surg
August 1993

Between 1989 and 1991, 17 children underwent 18 right ventricle-to-pulmonary artery conduit placement operations using a composite of an aortic or pulmonary valved homograft and a Hemashield extension to the ventricle. Hemashield is a collagen-coated knitted Dacron graft with excellent compliance and hemostatic properties. Diagnoses included tetralogy of Fallot with pulmonary atresia (7), truncus arteriosus (6), and complex transposition of the great arteries (4). Mean age at conduit placement was 4.9 +/- 4.2 years, and all patients survived. At a mean follow-up of 14 +/- 4 months, postoperative Doppler echocardiographic gradients between the ventricle and pulmonary artery ranged from less than 20 to 60 mm Hg. At cardiac catheterization 13 +/- 3 months postoperatively (6 patients), the systolic pressure gradient across the conduits ranged from 14 to 90 mm Hg (mean gradient, 59 +/- 29 mm Hg). Conduit obstruction, when present, was demonstrated angiographically to be in the Hemashield portion and led to early conduit replacement six times in 5 patients (33% of operations) within 10 to 18 months (mean time, 14 months) after insertion of the original conduit. Pathologic examination of the explanted conduits revealed the obstruction to be a thick neointimal peel that was impossible to separate from the Hemashield graft. Failure of the Hemashield as an extension for ventricle-to-pulmonary artery conduits secondary to accelerated neointimal formation has led us to abandon its use in clinical practice.

Duke Scholars

Published In

Ann Thorac Surg

DOI

ISSN

0003-4975

Publication Date

August 1993

Volume

56

Issue

2

Start / End Page

277 / 281

Location

Netherlands

Related Subject Headings

  • Respiratory System
  • Pulmonary Artery
  • Methods
  • Infant, Newborn
  • Infant
  • Humans
  • Heart Ventricles
  • Heart Defects, Congenital
  • Graft Occlusion, Vascular
  • Foreign-Body Reaction
 

Citation

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ICMJE
MLA
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Kobayashi, J., Backer, C. L., Zales, V. R., Crawford, S. E., Muster, A. J., & Mavroudis, C. (1993). Failure of the Hemashield extension in right ventricle-to-pulmonary artery conduits. Ann Thorac Surg, 56(2), 277–281. https://doi.org/10.1016/0003-4975(93)91159-k
Kobayashi, J., C. L. Backer, V. R. Zales, S. E. Crawford, A. J. Muster, and C. Mavroudis. “Failure of the Hemashield extension in right ventricle-to-pulmonary artery conduits.Ann Thorac Surg 56, no. 2 (August 1993): 277–81. https://doi.org/10.1016/0003-4975(93)91159-k.
Kobayashi J, Backer CL, Zales VR, Crawford SE, Muster AJ, Mavroudis C. Failure of the Hemashield extension in right ventricle-to-pulmonary artery conduits. Ann Thorac Surg. 1993 Aug;56(2):277–81.
Kobayashi, J., et al. “Failure of the Hemashield extension in right ventricle-to-pulmonary artery conduits.Ann Thorac Surg, vol. 56, no. 2, Aug. 1993, pp. 277–81. Pubmed, doi:10.1016/0003-4975(93)91159-k.
Kobayashi J, Backer CL, Zales VR, Crawford SE, Muster AJ, Mavroudis C. Failure of the Hemashield extension in right ventricle-to-pulmonary artery conduits. Ann Thorac Surg. 1993 Aug;56(2):277–281.
Journal cover image

Published In

Ann Thorac Surg

DOI

ISSN

0003-4975

Publication Date

August 1993

Volume

56

Issue

2

Start / End Page

277 / 281

Location

Netherlands

Related Subject Headings

  • Respiratory System
  • Pulmonary Artery
  • Methods
  • Infant, Newborn
  • Infant
  • Humans
  • Heart Ventricles
  • Heart Defects, Congenital
  • Graft Occlusion, Vascular
  • Foreign-Body Reaction