[Experience with a prosthesis of the pulmonary artery trunk at the A.N. Bakulev Institute of Cardiovascular Surgery, Academy of Medical Sciences, USSR].

From April 1975 to March 1991 sixty-four operations were carried out on 61 patients with various congenital heart diseases attended by impaired anatomical connection between the right ventricle and the pulmonary arteries. The patients' ages ranged from 9 months to 28 years (8 years on average). The most frequent clinical diagnoses were total transposition of the great vessels with ventricular septal defect and stenosis of the pulmonary artery (26 cases), type I common arterial trunk (14), Fallot's tetralogy (11 cases). Origin of the aorta and pulmonary artery from the right ventricle with stenosis of the pulmonary artery was encountered in 5 cases, origin of the aorta and pulmonary artery from the left ventricle with stenosis of the pulmonary artery in 4, and type II atresia of the pulmonary artery in one case. Three patients were reoperated on (reimplantation of an artificial pulmonary trunk). Synthetic prostheses with a biological (xenoaortic) valve made at the Institute, Bjerk-Sheily (USA) and Tascon Medical Technology (USA) "conduits", and synthetic prostheses devoid of valves were used. A "fresh" aortic alloprosthesis was used in one case. A statistically significant tendency towards reduction of operative mortality has been recorded (the mortality rate for the last 5 years is 14%). The late-term postoperative results were studied in 30 patients in follow-up periods of 12 months to 14.5 years (5 years and 5 months on average). Analysis of the late-term results shows the method to be highly effective. Stenosis of the prosthesis is the most significant problem of the late-term period.