New findings from F. Godart and co-authors in the area of tetralogy of fallot published
2009 JUN 8 - (NewsRx.com) -- According to recent research from Lille, France, "Off-pump valve replacement using self-expandable stents is an emerging technique for pulmonary valve disease. However, significant limitations are the lack of easily available valve substitute to be inserted within the stent and, in the setting of repaired tetralogy of Fallot, the existence of huge pulmonary trunk." "We report the first experimental results of a transventricular approach using a decellularized porcine xenograft mounted in a self-expandable stent. Pulmonary valve replacement was realized in 15 lambs by direct access of the infundibulum through a left thoracotomy, combined with pulmonary artery banding. Animals were followed by transthoracic echocardiography and, after control hemodynamic study, were electively killed either at day 7, month 1, or month 4 after implantation. Implantation succeeded in all lambs. Two animals died after implantation (1 pneumothorax and 1 endocarditis). Doppler echocardiographic follow-up did not show any significant transvalvular gradient and showed only mild pulmonary regurgitation. The hemodynamic control before termination revealed a systolic pulmonary valve gradient of 18.5 +/- 12.4 mm Hg at 1 week (n = 4), 13.5 +/- 10.6 mm Hg at 1 month (n = 4), and 4.3 +/- 4.9 mm Hg at 4 months (n = 5). Gross examination demonstrated the presence of connective tissue between the valved stent and pulmonary wall, which increased with time. Fifteen lambs underwent successful deployment of a self-expandable valved stent in the pulmonary position using a transventricular approach," wrote F. Godart and colleagues. The researchers concluded: "This technique combined with pulmonary artery banding could be a therapeutic option for pulmonary insufficiency after repair of tetralogy of Fallot with a transannular patch." Godart and colleagues published their study in the Journal of Thoracic and Cardiovascular Surgery (Experimental off-pump transventricular pulmonary valve replacement using a self-expandable valved stent: A new approach for pulmonary incompetence after repaired tetralogy of Fallot' Journal of Thoracic and Cardiovascular Surgery, 2009;137(5):1141-1145). For additional information, contact F. Godart, CHRU Lille, Hopital Cardiology, Service Malad Cardiovascular Infantiles & Congenitales, F-59037 Lille, France. Publisher contact information for the Journal of Thoracic and Cardiovascular Surgery is: Mosby-Elsevier, 360 Park Avenue South, New York, NY 10010-1710, USA. Keywords: France, Lille, Angiology, Biotechnology, Cardiography, Cardiology, Cardiovascular, Coronary Artery Disease, Echocardiography, Heart Disease, Heart Valve Disease, Pulmonary Artery, Surgery, Tetralogy Of Fallot, Thoracotomy, Xenograft, Xenotransplantion. This article was prepared by Cardiovascular Week editors from staff and other reports. Copyright 2009, Cardiovascular Week via NewsRx.com.
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