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Polytetrafluoroethylene Valved Conduit and Patch with Bluging Sinus Improved Production and Experimental Study

Author: ZhaoJing
Tutor: WangHuiShan
School: Liaoning Medical
Course: Surgery
Keywords: valved conduit actifical composition right ventricular outflow tract reconstruction congenital heart disease
CLC: R654.2
Type: Master's thesis
Year: 2011
Downloads: 7
Quote: 0
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Abstract


ObjectiveSince 1955, Lillehei first reported the use of cross valve ring patching in the correction of the right ventricular outflow tract (RVOT) stenosis, in 1963, Klinner and his colleagues reconstructed the RVOT with valveless conduit in the correction of the Tetralogy of Fallot defects, and in 1964, Rasteli corrected pulmonary atresia by reconstructing the right ventricular-pulmonary outflow tract using valveless conduit made by autologous pericardium, people have got a better recognition of the use of extracardiac conduit for the reconstruction of the RVOT in the corrections of series of complex right ventricular-pulmonary arterial defects. In this study, we mainly construct right ventricular valved conduits using PRECLUDE pericardium and Gore-Tex artificial vessel as valve and vessel material respectively. Our aim is to standardize the producing craft and the process flow, and also to observe the medium- and long-term effects in clinical application.Materials and methods1. Adjust the temperature by high temperature chamber, accommodate the pressure by air compressor, to determine the required optimum forming temperature, pressure and time. Cut the PRECLUDE into the valve that fit to the sinus cavity, and seam it to the sinus cavity by using continuous suture.2. Pigs were operated with the blood vessel that we made. right ventricular systolic pressure and pulmonary artery pressure were measured before closing the thoracic incisions, arteriae aorta pressure was recorded by invigilator when operating and postoperative.To compare the pulmonary artery systolic pressure, pulmonary artery systolic pressure / arteriae aorta systolic pressure and right ventricular - pulmonary arterial pressure difference between preoperative and postoperative,to check the pigs regularity for reviewing the funct of the valve that we made.Results1. The proportionality of Sinus Depth and Ridge Radius that we need is 1:4, so the pressure maintained at 100kpa, sustained pressing; Temperature would be 180℃, keeped on 30 minutes, sinus cavity formed with satisfactory results.2. The animal experiments: pressure measurement: pulmonary artery systolic pressure of preoperative were 22.00±3.61, pulmonary artery systolic pressure of postoperative were 23.00±3.39,0.2 <P <0.4; pulmonary artery systolic pressure / aortic systolic blood pressure of preoperative were 0.28±0.01, postoperative were 0.29±0.01,0.1 <P <0.2; right ventricular - pulmonary arterial pressure difference of preoperative were 4.00±2.24, postoperative were 4.20±2.59, P> 0.5; There are not yet considered the difference between preoperative and postoperative3. Echocardiography examination of a week after operating: 1 case had no pulmonary regurgitation, 1 case had mild pulmonary regurgitation, no case had moderate and ponderosu pulmonary regurgitation, the valves opened and closed were well. At 1、3、6 months after the operation, the datas were all 1 cases, 0 case and 0 case, the valves were well,too.Conclusion1. Repeated experiments, the producing craft and the process flow of using PRECLUDE pericardium and Gore-Tex artificial vessel as valve and vessel material respectively is that the pressure should be maintained at 100kpa continuously with air compressor, at the same time, the Gore-Tex vascular should be heated to 180℃by High-temperature chamber, for 30 minutes. The result is satisfactory.2 . Using PRECLUDE pericardial material for the valve, and Gore-Tex vascular grafts material for the right heart chamber sinus valved conduit to right ventricular outflow tract reconstruction has good prospects for development.

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CLC: > Medicine, health > Surgery > Of surgery > Cardiovascular and lymphatic system surgery > Heart
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