SURGICAL PATHOLOGY OF OBSTRUCTED, RIGHT-SIDED, PORCINE-VALVED EXTRA-CARDIAC CONDUITS

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  • 1 January 1983
    • journal article
    • research article
    • Vol. 107  (8) , 400-405
Abstract
Specimens (37) were available from 39 children and adolescents with congenital heart disease who had operations on the Mayo Clinic (Rochester, Minnesota, USA) to replace obstructed Hancock conduits that were implanted 17-93 mo. (mean 62 mo.). Stenosis affected the porcine valve alone in 17 (46%), the synthetic graft alone in 11 (30%), both the valve and the graft in 6 (16%), and other sites in 3 (8%). Valvular stenosis resulted from degenerative changes with secondary thrombosis and calcification, whereas insufficiency resulted from cuspid tears, thrombotic adhesions and endocarditis. Nonvalvular obstruction resulted from progressive thickening of fenestrated neointimae, owing to organization of thrombotic debris lining the interface between the conduit and this tissue. Late postoperative conduit stenosis may develop asymptomatically and unpredictably by several different mechanisms.