pulmonary allograft stenosis

[mitchner9g]

Hi Friends -

Wondering if any of you have had experience with a stenotic pulmonary allograft? Mine's been classified as severe, so surgical intervention necessary. Cardiologist not sure yet: Possible action could involve a balloon/stent application, or an entirely new valve/conduit.

Wondering what you had done?

This is my second pulmonary valve. The original one was excised for a Ross procedure some years ago and replaced with an allograft. Last year I had a bioprosthesis installed in the aortic position and another homograft for the pulmonary.

Thank you in advance!

Adam

 

[Lynlw]

Adam,I'm not sure where your conduit is, but Justin has a right ventricle to pulmonary artery conduit. Is the valve where the stenosis is or the conduit? Justin has had stenosis in the conduit a few times (never even had a pulm valve until 2 years ago) sometimes they've opened them in the cath lab with balloons and stents he also has had the conduit replaced and his surgery last month was just a section of his conduit replaced. What kind of intervention he has depends alot on where the stenosis is located and if they can help him in thecath lab w/balloons or stents or not. His current conduit is a section of dacron then a bovine valve,then more dacron that he got 2 years ago,the last stenosis was rightwhere the conduit was sewn to theright ventricleso it wasn't a spot they could help w/stent whichis why they had to replace that section.
Do you/they have any idea why yours is blocked already? Justin's heart is very forward and the conduit is on top of that,so part of his problem was the sternum pressing it.
Sorry if that wasn't very helpful and gave you more questions than answers,lyn

 

[mitchner9g]

Adam,I'm not sure where your conduit is, but Justin has a right ventricle to pulmonary artery conduit. Is the valve where the stenosis is or the conduit? Justin has had stenosis in the conduit a few times (never even had a pulm valve until 2 years ago) sometimes they've opened them in the cath lab with balloons and stents he also has had the conduit replaced and his surgery last month was just a section of his conduit replaced. What kind of intervention he has depends alot on where the stenosis is located and if they can help him in thecath lab w/balloons or stents or not. His current conduit is a section of dacron then a bovine valve,then more dacron that he got 2 years ago,the last stenosis was rightwhere the conduit was sewn to theright ventricleso it wasn't a spot they could help w/stent whichis why they had to replace that section.
Do you/they have any idea why yours is blocked already? Justin's heart is very forward and the conduit is on top of that,so part of his problem was the sternum pressing it.
Sorry if that wasn't very helpful and gave you more questions than answers,lyn

Hi Lyn - These are all great questions, I'll bring them to my next appointment.

My understanding is that the pulmonary valve and surrounding conduit is what was replaced on my right side. My cardiologist is unsure what caused it; possibly due to being a small valve, but she has not spoken with the surgeon about why they chose to place one of its size. There could be size/orientation issues much like your Justin has but I've not heard them.

It's interesting to know that they placed a bovine valve on Justin's right side. I heretofore had not heard that that was an option.

Thanks for your response!
Adam

 

[Lynlw]

I saw you have Congenital Heart Defects (CHD). I'm not sure what you have/or know about, but many adults/kids that have "Tetrology of fallot" part of their repair involves a pulm valve or valve/conduit (like justin's) and I know of many that either have bovine or pig.
Another great place to look for advice (or more questions to ask lol) is theforum at the Adult CHD org. you have to register to read them http://www.achaheart.org/for_members/ but it is a great site.Lyn