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

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. Among 205 patients receiving cryopreserved homografts for reconstruction of the RVOT between November 1985 and A...

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Bibliographic Details
Published in:Circulation (New York, N.Y.) N.Y.), 2000-11, Vol.102 (19 Suppl 3), p.III130-III-135
Main Authors: Tweddell, J S, Pelech, A N, Frommelt, P C, Mussatto, K A, Wyman, J D, Fedderly, R T, Berger, S, Frommelt, M A, Lewis, D A, Friedberg, D Z, Thomas, Jr, J P, Sachdeva, R, Litwin, S B
Format: Article
Language:English
Subjects:
Adolescent
Adult
Age Distribution
Aortic Valve - transplantation
Cardiac Surgical Procedures - mortality
Child
Child, Preschool
Cryopreservation
Disease-Free Survival
Follow-Up Studies
Graft Survival
Heart Defects, Congenital - complications
Heart Defects, Congenital - surgery
Humans
Infant
Infant, Newborn
Middle Aged
Multivariate Analysis
Proportional Hazards Models
Pulmonary Valve - transplantation
Risk Factors
Survival Rate
Transplantation, Homologous - statistics & numerical data
Ventricular Outflow Obstruction - etiology
Ventricular Outflow Obstruction - surgery
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Summary: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. 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
ISSN:0009-7322
1524-4539
DOI:10.1161/01.cir.102.suppl_3.iii-130