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April 1, 2008Journal of Cardiovascular Medicine

Conduit failure rates at 2 years were 9-55% for homografts, 35% for stented xenografts, and 25% for stentless xenografts, with 5-year freedom from reoperation varying widely by conduit type.

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Why the study?

What are the clinical outcomes and failure rates of various valved conduits used for right ventricular outflow tract reconstruction?

Population

Patients undergoing right ventricular outflow tract (RVOT) reconstruction

Comparison

Valved conduits vs Comparison among different conduit types

Design

Review

Follow-up

Up to 15 years

Key result

Conduit failure rates at 2 years were 9-55% for homografts, 35% for stented xenografts, and 25% for stentless xenografts, with 5-year freedom from reoperation varying widely by conduit type.

Authors

SYShi‐Min YuanDMDavid MishalyASAmihay Shinfeld

Discussion

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Member takes

Overview

Variable conduit durability may inform individualized RVOT reconstruction; leaves open optimal choice pending prospective trials.

Structured PICO

What are the clinical outcomes and failure rates of various valved conduits used for right ventricular outflow tract reconstruction?

P
Population
Review of English language articles from MEDLINE evaluating clinical outcomes of various valved conduits for right ventricular outflow tract reconstruction.
I
Intervention
Valved conduits (homograft, stented xenograft, stentless xenograft, and autologous tissue valved conduit)
C
Comparator
Comparison among different conduit types
O
Outcome
Clinical outcomes including early and late mortalities, conduit failure, conduit reoperation, reoperation-free interval, actuarial freedom from reoperation, and survival rateshard clinical

Homografts remain the most commonly used RVOT conduit with excellent characteristics, while alternatives like Contegra and Hancock offer acceptable intermediate to long-term results despite inevitable eventual conduit failure.

Limitations

  • Mechanisms involved in conduit failure are unknown.
  • Data for long-term follow-up of autologous monocusp pulmonary artery conduits are lacking.

Cite This Study

Yuan et al. (2008) conducted a review in Right ventricular outflow tract (RVOT) reconstruction. Valved conduits (homograft, stented xenograft, stentless xenograft, autologous tissue) vs. Various conduit types compared to each other was evaluated on Conduit failure and actuarial freedom from reoperation. Conduit failure rates at 2 years were 9-55% for homografts, 35% for stented xenografts, and 25% for stentless xenografts, with 5-year freedom from reoperation varying widely by conduit type.

synapsesocial.com/papers/6a93d9795e7ae87f038f91dfhttps://doi.org/10.2459/jcm.0b013e32821626ce
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