PHYSICAL AND MECHANICAL PROPERTIES OF CONDUITS DURING THE FORMATION OF THE OUTFLOW TRACT INTO THE PULMONARY ARTERY

Highlights

We have evaluated the rigidity and distensibility of conduits in the long-term period using transthoracic echocardiography. The assessment of elastic properties will make it possible to predict degenerative changes in the conduit and choose the optimal prosthesis.

Abstract

Aim. To evaluate changes in the rigidity and distensibility of conduits in patients after the formation of an outflow tract into the pulmonary artery in comparison with the control group of “healthy” children.

Methods. The prospective non-randomized two-center study included 58 people with right ventricular dysfunction who underwent primary conduit implantation between the ages of 3 and 15 years. To assess the elastic properties of the pulmonary artery, a control group of 25 patients (healthy children who agreed to participate in the study) was introduced. The study was carried out at the Meshalkin National Medical Research Center and the Almazov National Medical Research Centre. All patients were divided into 4 groups: healthy children (n = 25), formation of the outflow tract with a pulmonary homograft (n = 28), and formation of the outflow tract with Contegra conduit (n = 19), formation with a xenopericardial conduit (n = 11).

Results. The only differences between the groups were the RV EDV index, RV CVD index, RV FIP, severe pulmonary regurgitation, and tricuspid regurgitation. There is a significant difference between the groups in the long-term period (after 12 and 24 months), both in terms of rigidity and elasticity. The only difference in the long-term period after 12 months was the degree of tricuspid regurgitation, which was significantly lower in the control group. After 24 months, the peak gradient between the right ventricle and the pulmonary artery was different, which was significantly higher in the group of xenopericardial conduits and the degree of pulmonary regurgitation, which was significantly lower in the control group.

Conclusion. The conduits show higher stiffness in the long-term period in contrast to the normal pulmonary artery, which may affect the durability of the conduits. 

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