Follow-up of Shelhigh porcine pulmonic valve conduits

Abstract

BACKGROUND: We implanted Shelhigh porcine pulmonic valve conduits because of the limited availability of homografts in our country. The aim of this study was to evaluate the short-term results of SPVC. METHODS: From November 2002 to July 2005, the Shelhigh porcine pulmonic valve conduit was implanted in 73 patients (81 procedures) in the right ventricular outflow tract to correct congenital heart diseases. Operative procedures were Rastelli operation in 65, anatomic correction of atrioventricular discordance in 5, and Ross operation in 3. Age at operation was 6.8 +/- 7.5 years, including 11 patients under 1 year. The median conduit size was 18 mm (range, 12 to 24 mm). RESULTS: There was no operative mortality and 1 nonconduit-related late death (mean follow-up, 11.3 +/- 10.7 months). Ten conduits (12.3%, 7 patients) were removed at a median of 9.6 months (range, 2.5 to 25.4) owing to obstruction in 9 and pseudoaneurysm in 1. In the explanted conduits, we found a prominent intimal peel at the distal anastomosis without leaflet calcification. Freedom from reoperation at 24 months was 87% +/- 11.7% in large-sized conduits (>or=18 mm) and 62.8% +/- 10.6% in small-sized conduits (<or=16 mm). Especially, 12-mm sized conduit showed 33.3% freedom from reoperation during the first 12 months of follow-up. CONCLUSIONS: On the basis of our short-term results, Shelhigh porcine pulmonic valve conduits are not satisfactory. Small-sized conduits (<or=16 mm) fail earlier; large-sized conduits (>or=18 mm) fail after 2 years of implantation due to intimal peel formation at the distal segment.