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The Journal of Thoracic and Cardiovascular Surgery, Vol 86, 562-569, Copyright © 1983 by The American Association for Thoracic Surgery and The Western Thoracic Surgical Association

ARTICLES

The Hancock external valved conduit. A dichotomy between late clinical results and late cardiac catheterization findings

S Stewart, J Manning, C Alexson and P Harris

The Hancock external valved conduit was inserted in 18 children between 1974 and 1977. Seventeen patients survived operation and 15 are long- term survivors of 6 to 9 years. All patients have been closely followed up by the same pediatric cardiologist and each has undergone serial cardiac catheterization studies, generally performed at 1 and 6 years after operation. All long-term surviving patients have been in either New York Heart Association Class I or II. A few continue to take digoxin or diuretics. Cardiac catheterization demonstrated a gradient of 50 mm Hg or greater across the conduit in two of 16 patients 1 year after operation and in seven of 15 patients 6 years after operation. Five patients (30% of all long-term survivors) have had this conduit replaced and each has survived reoperation. The finding of a severe conduit gradient in one third of all long-term surviving patients is particularly bothersome since these patients were essentially asymptomatic. This study emphasizes the need for serial follow-up cardiac catheterization studies in all patients who receive the Hancock conduit.

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