Early and late results of fresh autologous pericardial valved conduits

Development of pediatric and congenital heart surgery in latin america: accomplishments and remaining challenges

In the last 70 years, congenital heart surgery has dramatically evolved, and Latin America has completed this journey with unique regional features. Since the first ligation of a patent arterial duct by Enrique Finochietto in 1941 in Buenos Aires, the development of congenital heart surgery was deeply influenced by funding restrictions and scarcity of technology. However, the determined work of cardiovascular surgery pioneers as Hugo Filipozzi, Euriclides Zerbini, and Adib Jatene in Brazil; Helmut Jaeger in Chile; Hugo Baz and Clemente Robles in Mexico; Alberto Bejarano in Colombia; and Mario Brea and Fernando Tricerri in Argentina made cardiac surgery with cardiopulmonary bypass available by the late 1950s. In the following five decades new generations of cardiovascular surgeons received the legacy of these outstanding leaders and made several important contributions to the field in tetralogy of Fallot, transposition of the great arteries, tricuspid atresia, single ventricle, truncus arteriosus, heart transplantation, and many others. Many centers in Latin America routinely perform congenital heart disease surgery with excellent results, covering the entire spectrum from the newborn to the adult congenital heart patient. The most important challenge that remains is to provide access to care to all children with congenital heart disease in Latin America, since currently only 42% of them receive surgical treatment.

Reconstruction of trileaflet pulmonary valve using autologous pericardium

Tetralogy of Fallot with atretic or absent pulmonary valve may require pulmonary valve replacement or reconstruction. We propose a technique of reconstruction of a trileaflet valve at the level of the pulmonary annulus using untreated autologous pericardium. Six cases operated upon, using this technique, had trivial pulmonary regurgitation with a median gradient of 24 mmHg (18-38) across the newly created valve. This approach can be considered in cases with limited availability of more suitable alternatives.