The Pericardial Membrane Pulmonary Monocusp

Surgical Technique and Early Results

Patrick Roughneen, Serafin Y. DeLeon, Sirish Parvathaneni, Frank Cetta, Benjamin Eidem, Dolores A. Vitullo

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Abstract Long‐term pulmonary insufficiency resulting from simple transannular patching of the right ventricle outflow tract will ultimately lead to deterioration in right ventricular function. Previously, monocusps constructed from xenografts, homografts, fascia lata, and autologous pulmonary artery wall have been utilized to minimize pulmonary regurgitation and its deleterious effect on right ventricular function. However, these tend to degenerate in the long term, necessitating reoperation. To circumvent this problem we have used a monocusp constructed from 0·1−mm polytetrafluorethylene (PTFE, pericardial membrane) clinically demonstrated to be resistant to issue ingrowth and degeneration. Seven children (5 tetralogy of Fallot, 2 pulmonary stenosis) who required division of a small pulmonary an‐nulus underwent monocusp construction with 0.1‐mm PTFE. Three patients had previous corrective surgery. One of these patients had a bovine pericardial monocusp placed 8 years previously, which degenerated. Of the remaining two patients, one had a pulmonary valvo‐tomy as a neonate, the other repair of tetralogy of Fallot with a transannular patch. At a mean (± standard deviation) follow up to 17 ± 5·8 months all patients are alive and are New York Heart Association (NYHA) Class I. Echocardiography demonstrates mild pulmonary insufficiency (PI) in 2 patients, mild to moderate PI in 4, and moderate to severe PI in 1. The presence of a pericardial membrane monocusp in the pulmonary position may, in the long term, prevent the deleterious effects of transannular patching on right ventricular dysfunction and be more resistant to degenerative changes characteristic of monocusps constructed of native pericardium or allogeneic tissue.

Original languageEnglish (US)
Pages (from-to)370-374
Number of pages5
JournalEchocardiography
Volume2
Issue number5
DOIs
StatePublished - 1985
Externally publishedYes

Fingerprint

Lung
Membranes
Right Ventricular Function
Tetralogy of Fallot
Polytetrafluoroethylene
Pulmonary Valve Insufficiency
Fascia Lata
Right Ventricular Dysfunction
Pulmonary Valve Stenosis
Pericardium
Reoperation
Heterografts
Pulmonary Artery
Heart Ventricles
Allografts
Echocardiography
Newborn Infant

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

Cite this

The Pericardial Membrane Pulmonary Monocusp : Surgical Technique and Early Results. / Roughneen, Patrick; DeLeon, Serafin Y.; Parvathaneni, Sirish; Cetta, Frank; Eidem, Benjamin; Vitullo, Dolores A.

In: Echocardiography, Vol. 2, No. 5, 1985, p. 370-374.

Research output: Contribution to journalArticle

Roughneen, Patrick ; DeLeon, Serafin Y. ; Parvathaneni, Sirish ; Cetta, Frank ; Eidem, Benjamin ; Vitullo, Dolores A. / The Pericardial Membrane Pulmonary Monocusp : Surgical Technique and Early Results. In: Echocardiography. 1985 ; Vol. 2, No. 5. pp. 370-374.
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abstract = "Abstract Long‐term pulmonary insufficiency resulting from simple transannular patching of the right ventricle outflow tract will ultimately lead to deterioration in right ventricular function. Previously, monocusps constructed from xenografts, homografts, fascia lata, and autologous pulmonary artery wall have been utilized to minimize pulmonary regurgitation and its deleterious effect on right ventricular function. However, these tend to degenerate in the long term, necessitating reoperation. To circumvent this problem we have used a monocusp constructed from 0·1−mm polytetrafluorethylene (PTFE, pericardial membrane) clinically demonstrated to be resistant to issue ingrowth and degeneration. Seven children (5 tetralogy of Fallot, 2 pulmonary stenosis) who required division of a small pulmonary an‐nulus underwent monocusp construction with 0.1‐mm PTFE. Three patients had previous corrective surgery. One of these patients had a bovine pericardial monocusp placed 8 years previously, which degenerated. Of the remaining two patients, one had a pulmonary valvo‐tomy as a neonate, the other repair of tetralogy of Fallot with a transannular patch. At a mean (± standard deviation) follow up to 17 ± 5·8 months all patients are alive and are New York Heart Association (NYHA) Class I. Echocardiography demonstrates mild pulmonary insufficiency (PI) in 2 patients, mild to moderate PI in 4, and moderate to severe PI in 1. The presence of a pericardial membrane monocusp in the pulmonary position may, in the long term, prevent the deleterious effects of transannular patching on right ventricular dysfunction and be more resistant to degenerative changes characteristic of monocusps constructed of native pericardium or allogeneic tissue.",
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