Document Detail

Mid- to long-term outcomes of cardiovascular tissue replacements utilizing homografts harvested and stored at Japanese institutional tissue banks.
MedLine Citation:
PMID:  21431482     Owner:  NLM     Status:  In-Data-Review    
PURPOSE: We reviewed our clinical experiences with cardiovascular homografts harvested and preserved at our institutional tissue banks.
METHODS: Since our bank was first established in Japan in 1990, 74 patients have undergone various surgical procedures using homografts. We classified them into five groups according to the procedure: Group I, subcoronary implantation of a homograft aortic valve; Group II, homograft aortic root replacement for active native or prosthetic endocarditis; Group III, homograft aortic replacement for mycotic aortic aneurysms or infected grafts; Group IV, pulmonary homografts in the Ross operation; and Group V, pulmonary homograft conduits for complex congenital heart diseases.
RESULTS: The 9- to 10-year survival rates were good and acceptable, respectively, for the patients in all five groups. The infection recurrence rate was low (8%). Cardiac event-free rates, including deaths, were 0.57 in Group I, 0.58 Group in II, 0.75 in Group III, 0.81 in Group IV, and 0.69 in Group V operations. The rates of structural homograft deterioration suggest that homografts deteriorate more rapidly after subcoronary implantation than aortic root replacements (P = 0.058).
CONCLUSIONS: Subcoronary implantation should probably be abandoned for routine aortic valve replacement, but the continued use of homografts will provide valuable alternatives for patients with active infectious cardiovascular diseases. For the Ross operation, pulmonary valve homografts showed good durability.
Soichiro Kitamura; Toshikatsu Yagihara; Junjiro Kobayashi; Hiroyuki Nakajima; Koichi Toda; Tomoyuki Fujita; Hajime Ichikawa; Hitoshi Ogino; Takeshi Nakatani; Shigeki Taniguchi
Publication Detail:
Type:  Journal Article     Date:  2011-03-23
Journal Detail:
Title:  Surgery today     Volume:  41     ISSN:  1436-2813     ISO Abbreviation:  Surg. Today     Publication Date:  2011 Apr 
Date Detail:
Created Date:  2011-03-24     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9204360     Medline TA:  Surg Today     Country:  Japan    
Other Details:
Languages:  eng     Pagination:  500-9     Citation Subset:  IM    
Department of Cardiovascular Surgery, National Cerebral and Cardiovascular Center, 5-7-1 Fujishirodai, Suita, Osaka, 565-8565, Japan.
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