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J Thorac Cardiovasc Surg 2003;125:727-728
© 2003 The American Association for Thoracic Surgery

Brief Communications

Initial experience with a stentless porcine bioprosthesis for right ventricular outflow tract reconstruction in children

From the Division of Pediatric Cardiac Surgery, Lucile Packard Children's Hospital at Stanford, Stanford University School of Medicine, Stanford, Calif.

Received for publication Dec 7, 2002. Accepted for publication Aug 27, 2002. Address for reprints: Michael D. Black, MD, Pediatric Cardiac Surgery, Lucile Packard Children's Hospital, Stanford University School of Medicine, Stanford, CA 94305-5407 (E-mail: Michael.black@leland.stanford.edu).

The first 20% of the full text of this article appears below.

Postoperative pulmonary regurgitation and stenosis still remain major determinants of long-term outcome in children requiring right ventricular outflow tract (RVOT) reconstruction.

Because of relatively low right-sided pressures, mechanical valves are at high risk for thrombosis, and long-term anticoagulation is disadvantageous in pediatric patients for obvious reasons. ¹ Because of accelerated calcification, bioprosthetic valves are, on the other hand, likely to undergo structural valve deterioration in younger patients. ²

The use of a stentless valve design, with improved shear stress on the valve leaflets, might prevent early valvular calcification. The Toronto stentless porcine valve (SPV; St Jude Medical, Inc, St Paul, Minn) incorporates a flexible Dacron ring with lack of an accompanying aortic wall. We hypothesized that these distinguishing characteristics might allow for improved long-term function when used in RVOT reconstruction in children.

Clinical summary

Nine patients (8 male patients and 1 female patient) born with tetralogy of Fallot underwent RVOT reconstruction with Toronto SPVs between March 1998 and July 2001. Mean age and weight were, respectively, 11.2 years (range, 4-17 years) and 41.6 kg . . . [Full Text of this Article]

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