Document Detail


Homograft implantation for aortic valve replacement since 15 years: results and follow-up.
MedLine Citation:
PMID:  20719726     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: The use of homografts in aortic valve replacement is an alternative to other prostheses and has been established in our department for 15 years.
METHODS: Since 1992, 360 homografts (HG) have been implanted in adult patients (mean age 51.6 years, 72.8% male). Prospective follow-up was done on an annual basis.
RESULTS: Thirty-day mortality was 5.0% (n = 17); after 5, 10, and 15 years, survival was 88.3%, 84.6%, and 76.0%, respectively. Out of 39 late deaths, 11 were valve-related (10 HG infections, 1 aortic aneurysm). Freedom from reoperation was 99.4% 1 year after operation; after 5, 10, and 15 years it was 94.1%, 78.2%, and 67.3%, respectively. Indications for HG explantation were graft infections (n = 20), calcification (n = 16), regurgitation > grade II (n = 17), perforation (n = 8), and paravalvular leakage (n = 1). Eleven transitoric ischemic attacks, 2 strokes, and 1 cerebral bleeding event were recorded. In echocardiography, the transvalvular pressure gradient changed from 10.55 to 15.02 (P = .004), 19.9 mmHg (P = .056), and 37 mmHg (not applicable) after 5, 10, and 15 years, respectively. Mean HG regurgitation was grade 0.49 before discharge and increased to 1.0 (P < .001), 0.91, and 2.5 after 5, 10, and 15 years, respectively. Ejection fraction increased from 61.9% to 64% after 5 years and to 66% after 10 years (P = .021) and then decreased to 63.5% after 15 years.
CONCLUSIONS: Comparing HG with other valve prostheses, survival and graft durability seem to be confirmed. They are vulnerable to infections. The hemodynamic performance is good, and hemorrhagic or thrombo-embolic events are rare.
Authors:
Eckehard Kilian; Florian Fries; Anke Kowert; Ferdinand Vogt; Eckart Kreuzer; Bruno Reichart
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The heart surgery forum     Volume:  13     ISSN:  1522-6662     ISO Abbreviation:  Heart Surg Forum     Publication Date:  2010 Aug 
Date Detail:
Created Date:  2010-08-19     Completed Date:  2011-01-04     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100891112     Medline TA:  Heart Surg Forum     Country:  United States    
Other Details:
Languages:  eng     Pagination:  E238-42     Citation Subset:  IM    
Affiliation:
Department of Cardiac Surgery, Ludwig-Maximilians-University, University Hospital Grosshadern, Munich, Germany. Ec.Ki@web.de
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Aged
Aged, 80 and over
Aortic Valve / microbiology,  transplantation*
Aortic Valve Insufficiency / surgery*,  ultrasonography
Cardiac Surgical Procedures / adverse effects,  mortality
Child
Echocardiography
Female
Follow-Up Studies
Hemodynamics
Humans
Infection / etiology
Kaplan-Meier Estimate
Male
Middle Aged
Postoperative Complications / surgery
Postoperative Period
Prospective Studies
Reoperation / statistics & numerical data
Time Factors
Transplantation, Homologous / adverse effects
Young Adult

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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