alexa Factors affecting longevity of homograft valves used in right ventricular outflow tract reconstruction for congenital heart disease.
Clinical Research

Clinical Research

Journal of Clinical Case Reports

Author(s): Tweddell JS, Pelech AN, Frommelt PC, Mussatto KA, Wyman JD,

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Abstract BACKGROUND: Few studies have explored the long-term function of cryopreserved homograft valves used for reconstruction of the right ventricular tract (RVOT) in patients with congenital heart disease. METHODS AND RESULTS: Among 205 patients receiving cryopreserved homografts for reconstruction of the RVOT between November 1985 and April 1999, the outcome of 220 homografts in 183 operative survivors was analyzed. There were 150 pulmonary and 70 aortic homografts used. Median age at implantation was 4.4 years (mean 6.9+/-7.6 years, range 3 days to 48 years). End points included (1) patient survival, (2) homograft failure (valve explant or late death), and (3) homograft dysfunction (homograft insufficiency or homograft stenosis). Survival was 88\% at 10 years. Freedom from homograft failure was 74+/-4\% at 5 years and 54+/-7\% at 10 years. Univariable analysis identified younger age, longer donor warm ischemic time, valve Z: value <2, and previous procedure as risk factors for homograft failure and dysfunction. Aortic homograft type and extracardiac operative technique predicted homograft failure but not dysfunction. For patients This article was published in Circulation and referenced in Journal of Clinical Case Reports

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