Failure of cryopreserved homograft valved conduits in the pulmonary circulation.

Academic Article

Abstract

  • BACKGROUND: This study evaluates our experience with the cryopreserved homograft valved conduit used for reconstruction of the pulmonary circulation in patients with congenital heart disease. METHODS AND RESULTS: Between July 1, 1985, and December 31, 1990, 219 patients had cryopreserved homograft extracardiac valved conduits placed in the pulmonary circuit. Average age at operation was 7.2 years. Of these, 132 patients had a pulmonary homograft, and 87 had an aortic homograft. Twenty-four patients (11%) died in hospital. Hospital survivors (n = 195) have been followed an average of 29.8 months (SD, +/- 18.4 months). Fourteen patients died during follow-up, almost all related to the complexity of their original cardiac malformation. Thirty-two patients (15%) have required reoperation for conduit-related problems. Actuarial freedom from conduit reoperation is 55 +/- 12% at 5 years. The most common indication for reoperation was calcific stenosis (n = 27). Other indications for reoperation were pseudoaneurysm (n = 2), conduit infection (n = 2), and pulmonary insufficiency (n = 1). Reoperation rate for patients with aortic homografts (16 of 87) compared with that for pulmonary homografts (16 of 132) was not significantly different by the actuarial method. CONCLUSIONS: Long-term function of cryopreserved homograft valved conduits in the pulmonary circulation is disappointing.
  • Authors

    Published In

  • Circulation  Journal
  • Keywords

  • Actuarial Analysis, Aortic Valve, Child, Child, Preschool, Cryopreservation, Female, Graft Occlusion, Vascular, Heart Defects, Congenital, Heart Valve Prosthesis, Humans, Male, Prosthesis Failure, Pulmonary Artery, Pulmonary Valve, Reoperation
  • Author List

  • Cleveland DC; Williams WG; Razzouk AJ; Trusler GA; Rebeyka IM; Duffy L; Kan Z; Coles JG; Freedom RM
  • Start Page

  • II150
  • End Page

  • II153
  • Volume

  • 86
  • Issue

  • 5 Suppl