Long-term sequential hemodynamic evaluation of right ventricular outflow tract reconstruction using a valve mechanism

From May, 1972, to May, 1978, right ventricular outflow tract reconstruction was performed in 20 patients with congenital heart disease. A monocusp patch constructed entirely of glutaraldehyde-stabilized calf pericardium, was employed in 19 patients, and a composite conduit consisting of a three-cusp pericardial xenograft valve in a Dacron tube was used in 1 patient. There were 2 hospital deaths (10%) and no late deaths. The follow-up ranged from 5 to 75 months (mean, 55.7 +/- 4.6 months; total, 1,002 patient months). Eleven patients had completed 5 years of follow-up at the time of writing. Hemodynamic studies were performed in 10 patients at an average of 40 months after operation and the right ventricle-pulmonary artery systolic gradient was 9.3 +/- 1.7 mm Hg. This was not significantly different in 6 patients who had a second postoperative catheterization at 51.8 +/- 2.0 months following operation. Angiography showed fully mobile, thin valve cusps. These results compare well with those reported with other types of conduits, particularly with reference to relief of obstruction.