Right ventricular outflow tract reconstruction with a XXXX pericardial monocusp patch. Long-term clinical and hemodynamic evaluation.

@entity1 @entity338 @entity850 @entity204 @entity291 @entity4297
A @entity291 pericardial monocusp patch was used in 21 @entity1 with a variety of @entity4297 for reconstruction of obstructed right ventricular outflow tract. Two early postoperative @entity204 and one late @entity204 occurred, and these were unrelated to monocusp patch function. Survivors have completed a mean follow-up of 113 months (range 29 to 141 months). They are all asymptomatic, and their physical activity is unrestricted. Seventeen @entity1 have completed more than 5 years of follow-up and, of these, 11 @entity1 have completed more than 10 years of follow-up. Eleven @entity1 have been reinvestigated by sequential postoperative hemodynamic and angiographic studies at mean periods of 16, 48, and 100 months. The mean peak systolic pressure gradient across the right ventricular outflow tract under conditions of normal flow was 13 +/- 2.4 mm Hg at 16 months, and it has shown no significant change when measured at intervals of up to 124 months after the operation. This lack of change suggests effective long-term relief of the outflow tract obstruction. Serial radiographic screening of all @entity1 and angiographic studies in 11 @entity1 disclosed no evidence of graft calcification, @entity850 , or dilatation. The monocusp valve remained functional and effectively abolished or reduced @entity338 . In 11 @entity1 who had residual @entity338 , the regurgitation was mild and, up to 12 years after operation, had not resulted in any adverse clinical sequelae.
