Fate of equine pericardial roll conduit for Rastelli operation during long-term follow-up.
Abstract: Right ventricular outflow tract obstruction is a frequent condition after Rastelli operation. Although several modifications have been reported elsewhere, ideal conduit has not been developed yet during long-term follow-up. We reviewed our experiences over 15-year long-term follow-up with patients who underwent Rastelli operation using house-made equine pericardial roll graft. Methods: Since June 1981, 16 patients underwent Rastelli operation with the pericardial roll graft. Median follow-up time was 15.6 years (7.3-26.8 years). Results: Twelve out of 16 patients using pericardial roll graft with (n = 6) or without (n = 6) cusps underwent 13 reoperations during the follow-up period. Median time from first Rastelli to re-do operation was 8.4 years with median time to reoperation of 8 years. Major indication for reoperation was conduit obstruction (n = 10), but not conduit regurgitation. Conduit problem includes kinking and compression of the graft. Reoperation procedures include 7 Danielson procedures, 2 patch augmentations, 1 homograft replacement, 1 pericardial roll graft, 1 expanded polytetrafluoroethylene tube graft replacement, and 1 patch closure for pulmonary artery aneurysm. Balloon angioplasty was not effective for pericardial roll conduit stenosis. Conclusions: We conclude that house-made equine pericardial roll graft was durable for certain time period, but conduit change may be inevitable. Because of excellent handling and wide application, further modification may be warranted.
Publication Date: 2008-04-02 PubMed ID: 18377488DOI: 10.1111/j.1747-0803.2007.00084.xGoogle Scholar: Lookup
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- Journal Article
- Cardiovascular Health
- Clinical Pathology
- Clinical Study
- Clinical Symptoms
- Diagnosis
- Disease Diagnosis
- Disease Etiology
- Disease Management
- Disease Treatment
- Equine Health
- Heart
- Horses
- Longitudinal Study
- Post-Operative Period
- Reproduction
- Surgery
- Veterinary Care
- Veterinary Medicine
- Veterinary Procedure
- Veterinary Research
Summary
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This study evaluates the long-term outcomes of using a house-made equine pericardial roll graft in Rastelli operations, a specific type of heart surgery. The researchers followed up with patients over 15 years and found that although the graft material was durable for a certain period, the likelihood of needing a follow-up operation due to conduit obstruction was high.
Research Objectives and Methods
- The aim of this study was to assess the long-term effectiveness of an equine pericardial roll graft when used for Rastelli operations.
- Rastelli operation is a type of cardiac surgery, usually performed on patients with a specific congenital heart defect known as transposition of the great arteries.
- Between June 1981 and the end of the study’s timeframe, the researchers had performed Rastelli operations on 16 patients using the equine pericardial roll graft.
- The median follow-up period for these patients was 15.6 years, ranging from 7.3 to 26.8 years.
Results and Findings
- Of the 16 patients in the study, 12 needed to undergo further operations during the follow-up period. Whether the initial graft incorporated cusps did not seem to influence the need for a reoperation.
- The median time lapse from the first Rastelli operation to the follow-up operation was 8.4 years, and the median time to need for reoperation was 8 years.
- The most common reason for a reoperation was conduit obstruction, rather than conduit regurgitation.
- Ideally, the conduit should remain open to allow blood flow, but in this case, it had become obstructed in most patients.
- Negative side effects included graft kinking and compression.
Conclusion and Suggestions for Future Research
- The study concluded that the equine pericardial roll graft lasted for a certain period of time but ultimately, reoperation was frequently needed due to conduit obstruction.
- The researchers suggested that while equine pericardial roll graft demonstrated good handling qualities and versatility in its applications, further modifications and improvements are required to increase its longevity in the patients.
- The study also mentioned that balloon angioplasty, a procedure to widen narrow or obstructed arteries or veins, was not effective for treating pericardial roll conduit stenosis or the narrowing of the conduit.
Cite This Article
APA
Takeuchi K, Murakami A, Sekiguchi A, Hirata Y, Maeda K, Kitahori K, Doi Y, Takamoto S.
(2008).
Fate of equine pericardial roll conduit for Rastelli operation during long-term follow-up.
Congenit Heart Dis, 2(2), 121-124.
https://doi.org/10.1111/j.1747-0803.2007.00084.x Publication
Researcher Affiliations
- Department of Cardiac Surgery, University of Tokyo Graduate of Medical School, Tokyo, Japan. koutakeuchi-circ@umin.ac.jp
MeSH Terms
- Adolescent
- Adult
- Animals
- Bioprosthesis / adverse effects
- Cardiac Surgical Procedures
- Follow-Up Studies
- Horses
- Humans
- Kaplan-Meier Estimate
- Pericardium
- Polytetrafluoroethylene
- Prostheses and Implants
- Reoperation
- Time Factors
- Ventricular Outflow Obstruction / surgery
Citations
This article has been cited 1 times.- Yamamoto H, Yamamoto F, Ishibashi K, Chida Y, Minamiya Y, Nanjo H. In situ replacement of the thoracic aorta using an equine pericardial roll graft for an aortobronchial fistula due to aortic rupture. Gen Thorac Cardiovasc Surg 2009 Aug;57(8):413-7.
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