Document Detail

Homografts for right ventricular outflow tract reconstruction in congenital heart disease.
MedLine Citation:
PMID:  9455784     Owner:  NLM     Status:  MEDLINE    
In 49 patients aged 2.2-34.8 (mean 11) years, homografts (20 aortic, 29 pulmonary) were implanted in the right ventricular outflow tract as an isolated procedure or part of corrective surgery for congenital heart disease: tetralogy of Fallot with pulmonary stenosis (23 cases), pulmonary atresia with ventricular septal defect (10 cases) truncus arteriosus (8 cases) or transposition of the great arteries with pulmonary stenosis (8 cases). Previous palliative procedures had been performed on 34 patients, and 37 had undergone repair of right ventricular outflow tract, with one to four sternotomies prior to homograft implantation. Homograft valve sizes ranged from 14 to 25 mm internal diameter. Concomitant intra- or extracardiac procedures were performed in 29 cases. Follow-up was complete at a mean of 3 +/- 0.3 (0-8) years. Early and total mortality was 2.0% (1/49), due to sepsis and multi-organ failure unrelated to the homograft. At follow-up all but one of the patients had an improved New York Heart Association function class. Eight patients (16.3%) with a mean age of 9.2 +/- 1.8 (2.8-15.5) years at implantation had homograft malfunction (stenosis in three, regurgitation in two and combined in three) at follow-up, averaging 4.1 +/- 1.0 (0.4-6.9) years, with no significant difference between aorta and pulmonary homograft subsets. Freedom from structural valve deterioration was 46.6 +/- 22% for pulmonary and 32.3 +/- 21.3% for aortic homografts at the 7-year follow-up (difference not significant). In two patients an aortic homograft was uneventfully replaced. In conclusion, homograft implantation in patients with right ventricular outflow tract obstruction improves function class and can entail low mortality and morbidity, even after multiple previous median sternotomies.
A E Fiane; H L Lindberg; E Seem; O R Geiran
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Scandinavian cardiovascular journal : SCJ     Volume:  31     ISSN:  1401-7431     ISO Abbreviation:  Scand. Cardiovasc. J.     Publication Date:  1997  
Date Detail:
Created Date:  1998-03-09     Completed Date:  1998-03-09     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  9708377     Medline TA:  Scand Cardiovasc J     Country:  NORWAY    
Other Details:
Languages:  eng     Pagination:  351-6     Citation Subset:  IM    
Department of Surgery A, Rikshospitalet, University of Oslo, Norway.
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MeSH Terms
Aortic Valve
Bioprosthesis* / adverse effects
Child, Preschool
Follow-Up Studies
Heart Defects, Congenital / surgery*
Heart Valve Prosthesis* / adverse effects
Heart Valve Prosthesis Implantation / mortality
Middle Aged
Postoperative Complications / mortality
Prosthesis Failure
Pulmonary Valve
Retrospective Studies
Survival Rate
Transplantation, Homologous* / adverse effects,  mortality

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