Midterm results of homografts in pulmonary position: a retrospective single-center study
- PDF / 781,141 Bytes
- 9 Pages / 595.276 x 790.866 pts Page_size
- 100 Downloads / 159 Views
ORIGINAL ARTICLE
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 Received: 9 April 2020 / Revised: 15 September 2020 / Accepted: 18 September 2020 # Indian Association of Cardiovascular-Thoracic Surgeons 2020, corrected publication 2020
Abstract Objective Valved conduits play a pivotal role in the right ventricular outflow tract (RVOT) reconstruction in patients with congenital heart disease (CHD), and valved homografts have become the most commonly used conduits in pediatric cardiac surgery. This study aimed to assess the midterm performance of aortic and pulmonary homografts used in pulmonary position in patients with CHD. Methods Ninety-eight patients underwent surgical RVOT reconstruction with a homograft from January 2012 to December 2017. We collected all patient details from the institute patient record system. Echocardiographic data were obtained from the records. Postoperative data included survival and follow-up echocardiography. The primary endpoints of the study were homograft failure, homograft dysfunction, and freedom from re-intervention. Results We observed allograft failure in two patients (2%), one each due to pseudo-aneurysm formation and infective endocarditis. There were 8 early deaths (8/98, 8.2%) and 9 late deaths (9/98, 9.2%). The mean survival time was 6.1 years, and the postoperative survival rate at 1 and 5 years was 89.73% and 82.65%, respectively. Homograft regurgitation and homograft dysfunction were higher in the pulmonary homograft group. However, the re-intervention rates were more in the aortic homograft (24.24%) group due to the higher incidence of calcification associated with them. Conclusion Homografts used for RVOT reconstruction provide excellent intermediate-term outcomes, irrespective of the type of homograft used. Pulmonary homografts are more durable than aortic homografts and provide satisfactory results even in infants. Keywords Congenital heart disease . Bicuspidization . Homografts . RVOT reconstruction
Introduction Homografts are among the many varieties of prosthetic materials used for right ventricular outflow tract (RVOT) reconstruction of congenital heart diseases (CHD). The first clinical use of homograft tissue in cardiac surgery was in 1948 when Robert Gross used cadaver arterial grafts to construct systemic to pulmonary artery shunts in patients with tetralogy of Fallot * Sabarinath Menon [email protected] 1
Department of Cardiothoracic and Vascular Surgery, Sree Chitra Tirunal Institute for Medical Sciences & Technology, Trivandrum, Kerala 695011, India
2
Department of Cardiology, Sree Chitra Tirunal Institute for Medical Sciences & Technology, Trivandrum, India
and for coarctation of the aorta repair [1]. Homograft valves have been first implanted in humans by Donald Ross in London [2] and Barratt-Boyes in Auckland [3] in 1962. Their use has been restricted by t
Data Loading...
