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DOI: 10.1055/s-0030-1269154
Mid-term experience with Hancock porcine-valved Dacron conduit for right ventricular outflow tract reconstruction
Objectives: Surgical reconstruction of the right ventricular outflow tract (RVOT) often requires implantation of a valved conduit. A single centre experience with the Hancock porcine valved Dacron conduit was retrospectively assessed.
Methods: The records of 63 patients who underwent RVOT reconstruction with implantation of Hancock-conduits between August 2000 and July 2010 were retrospectively reviewed. Median age was 13 years (range, 0.6–64 years), median weight 44kg (range, 6.5–75kg). Re-operations were performed in 52 patients (83%), and 31 patients (49%) had conduit-re-replacement. Patient and conduit survival were calculated by Kaplan-Meier method.
Results: Early Mortality was 4.8% and not related to conduit failure. Follow up was complete with a mean duration of 3.0±2.6 years. Patient survival after conduit implantation was 95% (95% confidence interval [CI], 90–100), 89% (95% CI, 79–99), and 84% (95% CI, 72–98) after 1, 3 and 5 years. Conduit failure occurred in six patients after a median of 5.6 years (range, 2.7–9.0 years). Conduit survival was 100%, 96% (95% CI, 89–100) and 83% (95% CI, 62–100%) after 1, 3 and 5 years, respectively. Mean systolic gradient over the stenotic conduit-valve was 87±11mmHg. Neither RVOT-aneurysm formation nor distal conduit stenosis occurred. Patients with conduit failure had significantly higher white blood cell count at postoperative day 9, 10 and 11 (p<0.05).
Conclusions: The Hancock conduit is a valuable option for pulmonary valve replacement. It is not associated with RVOT-aneurysm formation or distal conduit stenosis. A persisting peri-operative inflammatory reaction may be a predictor for later conduit failure.