Correction to: Midterm results of homografts in pulmonary position: a retrospective single-center study
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CORRECTION
Correction to: Midterm results of homografts in pulmonary position: a retrospective single-center study Javid Raja 1 & Sabarinath Menon 1 & Sameer Mohammed 1 & Sowmya Ramanan 1 & Sudip Dutta Baruah 1 & Arun Gopalakrishnan 2 & Baiju Sasi Dharan 1
# Indian Association of Cardiovascular-Thoracic Surgeons 2020
Correction to: Indian Journal of Thoracic and Cardiovascular Surgery https://doi.org/10.1007/s12055-020-01065-1 Discussant is missing in the original article and is shown below: Discussant: Dr Maruti Y Haranal, MCh Department of Pediatric Cardiac Surgery National Heart Institute Kuala Lumpur, Malaysia The current retrospective study reiterates few facts about the homograft use in establishing RV-PA continuity. It compares the midterm outcomes of pulmonary homograft versus aortic homograft in pulmonary position. The major drawback is the absence of randomization. Q1. According to authors severe homograft stenosis/ regurgitation is considered as homograft dysfunction. Going by this definition majority of graft dysfunctions are graft failures. This needs explanation. Ans. We have defined homograft dysfunction as presence of moderate or severe stenosis or insufficiency. We have defined homograft failure as explant of the valve for any reason beThe online version of the original article can be found at https://doi.org/ 10.1007/s12055-020-01065-1 * Sabarinath Menon [email protected] 1
2
Department of Cardiothoracic and Vascular Surgery, Sree Chitra, Tirunal Institute for Medical Sciences & Technology, Trivandrum, Kerala 695011, India Department of Cardiology, Sree Chitra Tirunal Institute for Medical, Sciences & Technology, Trivandrum, India
cause of any cause. Yes, homograft dysfunction is a precursor for homograft failure, but there could be other causes for homograft failure too, like infective endocarditis or pseudoaneurysm involving the homograft. Hence homograft dysfunction is an eventually inevitable result which progress over a period, while homograft failure is the explant of the homograft which could be either early or late after the surgery. Q2. Few patients who meet the criteria for graft failure by echocardiography are clinically asymptomatic. In such scenarios, how did authors decide on the patient management? Ans. Patients with moderate or severe homograft incompetence undergo a functional MRI and the protocols for pulmonary valve replacement are followed in these patients. Patients with homograft stenosis are followed -up more frequently with sequential echocardiograms and an initial exercise tolerance test. Presence of severe stenosis is considered as an indication for homograft replacement. Q3. Based on the Z values, how do authors select an appropriate homograft for a given patient? Ans. In younger patients, with body weight less than 20 kg, we prefer to select a homograft that matches a Z score of +2, provided there would be no compression of the homograft during sternal closure. In patients with body weight more than 20 kg, the general rule applied is to select a homograft
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