Efficacy of right ventricular outflow tract reconstruction with Gore-Tex monocusp valve: a short-term evaluation

Abstract

Objective To evaluate the short term efficacy of reconstruction of right ventricular outflow tract(RVOT)with 0.1 mm Gore-Tex monocusp valve. Methods From June 2002 to June 2013, 91 patients (51 males, 40 females) underwent reconstruction of RVOT with Gore-Tex monocusp valve to correct cardiac anomalies were enrolled, including 67 patients with tetralogy of Fallot(TOF)and pulmonary stenosis, 12 patients with TOF and pulmonary atresia, 5 patients with TOF and absent pulmonary valve, 3 patients with double outlet of right ventricle and pulmonary stenosis, 2 patients with complete transposition of great artery and 1 patient with ventricular septal defect and pulmonary stenosis. Results There was no operative death.The postoperative blood oxygen saturation was up to 96%-100%.PaO2 was 82-207 mmHg. The ratios of right ventricular systolic pressure and left ventricular systolic pressure were between 0.22 and 0.70.The gradient pressure between right ventricle and left or right pulmonary artery was less than 10 mmHg.Left ventricular ejection fraction (LVEF) was 0.53-0.80, right ventricular ejection fraction (RVEF) was 0.52-0.71, left ventricular end-diastolic volume index was 0.28-0.62 ml/m2. Early postoperative complications were present: pericardial effusion in 10 cases, hypoxemia (oxygenation index <150) in 8 cases, arrhythmia in 7 cases, low cardiac output syndrome in 5 cases and 4 cases of residual ventricular septal defects. All patients were followed up by echocardiography ranging from 3 to 48 months after the surgery. There were no death and complications. The 76 patients had normal valve active functions, 15 patients had single cusp fixed in the open state; 87 patients had no pulmonary stenosis, 4 patients had mild stenosis; 23 patients had mild pulmonary valve regurgitation, 6 patients had moderate regurgitation. Conclusions These results demonstrate that the surgical reconstruction of RVOT with 0.1 mm Gore-Tex monocusp valve could have satisfied clinical and hemodynamic effects in short term. Key words: Pulmonary valve stenosis; Pulmonary atresia; Polytetrafluoroethylene; Right ventricular outflow tract reconstruction; Monocusp valve