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Brazilian Journal of Cardiovascular Surgery

Print version ISSN 0102-7638

Rev Bras Cir Cardiovasc vol.7 no.2 São José do Rio Preto Apr./June 1992

 

ARTIGOS ORIGINAIS

 

Reconstrução arterial com tubo de pericárdio bovino corrugado

 

Arterial reconstruction with crimped bovine pericardial conduit

 

 

Cláudio A. SallesI; Nilzo A. M. RibeiroII; Renato A. K. KalilIII; Gilberto Lino VieiraI; Liberato S. S. SouzaI; Paulo M. BorémI; Miguel E. C. AndradeI; Rogério D. FaleirosI; Marcos A. M. Andrade JrI

IDo Hospital Felício Rocho de Belo Horizonte
IIDo Hospital Santa Isabel de Salvador
IIIDo Instituto de Cardiologia de Porto Alegre

Endereço para separatas

 

 


RESUMO

No período de agosto de 1989 a fevereiro de 1992, 32 pacientes foram submetidos a reconstruções vasculares utilizando-se condutos de pericárdio bovino corrugado preservado em glutaraldeído. A incorporação do principio crimping utilizado nas próteses vasculares sintéticas proporcionou tubos que mantêm sua forma cilíndrica, mesmo quando submetidos a curvaturas. Vinte e nove pacientes (Grupo I) eram portadores de doenças da aorta torácica e/ou abdominal, incluindo aneurismas, dissecções agudas, coarctação da aorta e lesão oclusiva aorto-ilíaca. A reconstrução da aorta torácica foi realizada em 25 pacientes (incluindo a substituição da valva aórtica em 10), da aorta abdominal em 2 e aorto-ilíaca em 2. Três pacientes (Grupo II), portadores de cardiopatias congênitas complexas, foram submetidos a reconstrução da via de saída do ventrículo direito em 2 e a operação de Fontan em 1. A mortalidade hospitalar no Grupo I foi 24% (7 pacientes), causada por baixo débito cardíaco em 4, recidiva precoce da dissecção em dois e infecção respiratória em 1. Seis destes óbitos ocorreram em pacientes operados na fase aguda de dissecção aórtica. Não houve nenhum óbito no Grupo II. Houve um óbito tardio no Grupo I devido a complicações metabólicas relacionadas a diabetes e insuficiência renal crônica. Esta experiência clínica inicial registrou um seguimento médico de 16 meses por paciente, com um máximo de 32 meses e não se verificou nenhuma complicação tardia relacionada ao conduto de pericárdio bovino corrugado.

Descritores: prótese arterial; prótese vascular; aneurismas de aorta, cirurgia.


ABSTRACT

From August 1989 to February 1992, 32 patients underwent vascular reconstructions using crimped bovine pericardial conduits processed in glutaraldehyde. The introduction of the crimping process used for synthetic vascular prosthesis provided circular tubes, which retain their shape with bending and avoid kinking. Twenty-nine patients (Group I) presented vascular lesions involving the thoracic and/or abdominal aorta, including aneurysms, acute dissections, coarctation and aorto-iliac lesion. The thoracic aortic reconstruction was performed in 25 patients, including aortic valve replacement in 10, the abdominal aorta in 2, and the aortic bifurcation in 2. Three patients (Group II) with complex congenital heart lesions underwent reconstruction of the right ventricular outflow tract in 2, and the Fontan operation in 1. Hospital mortality in Group I was 24% (7 patients). Causes of death were low cardiac output in 4, recurrence of aortic dissection in 2 and respiratory infection in 1. Six of them had been operated upon as emergencies due to acute aortic dissection. All patients in group II survived the operation. There was 1 late death in group I due to methabolic complications related to diabetes and chronic renal failure. This initial clinical experience showed a mean follow-up of 16 months per patient and the longest follow-up was 32 months. It was not observed any late complication related to the crimped bovine pericardial conduit up-to-date.

Descriptors: arterial prosthesis; vascular prosthesis; aneurysms, aortic, surgery.


 

 

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Endereço para separatas:
Cláudio A. Salles
Av. Celso Porfirio Machado, 620
30330 Belo Horizonte, MG, Brasil

 

 

Trabalho realizado no Hospital Felício Rocho, Belo Horizonte, MG, Hospital Santa Isabel, Salvador, BA e Instituto de Cardiologia, Porto Alegre, RS, Brasil.
Apresentado ao 19º Congresso Nacional de Cirurgia Cardíaca. Sáo Paulo, SP, 7 a 9 de maio, 1992.
Laureado com o Prêmio Nacional de Cirurgia Cardíaca - 1992.

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