Long-Distance Procured Homograft-valved Conduit Replacement for Congenital Heart Disease: Initial Experience with 10 Cases

Abstract

We review our experience from January 1987 to September 1992 with the surgical treatment of complex congenital malformations requiring an extracardiac homograft-valved conduit. There were 10 patients in the series; 7 pulmonary and 3 aortic homografts were implanted. Ages ranged from 1 month to 26 years (mean 7.9). There were 4 cases of hospital mortality, none related to the homograft itself. The major postoperative complication was low cardiac output syndrome. The 6 survivors have been followed between 3 months and 5 years and no dysfunction of the valved homograft, thromboembolism, or hemolysis have been recorded. All the survivors are symptom-free with a good quality of life. The use of homografts is advised in selected cases of right and left ventricular tract reconstruction for congenital heart disease; homografts are easy to handle and offer several technical advantages over prosthetic tissues.

Get full access to this article

View all access options for this article.

References

Kirklin

Barratt-Boyes

. Aortic valve disease. In: Cardiac surgery. New York: Wiley & Sons; 1986:373–429.

Ross

Somerville

Correction of pulmonary atresia with a homograft aortic valve. Lancet 1966;2:1446–7.

Bodnar

Wain

Martelli

Ross

. Long-term performance of 580 homograft and autograft valves used for aortic valve replacement. Thorac Cardiovasc Surgeon 1979;27:31–5.

Viridis

Monro

Ross

. Eleven-year experience of aortic valve replacement with antibiotic-sterilized homograft valves in Southampton. Thorac Cardiovasc Surgeon 1986;34:277–82.

Bissett

III Schwartz

Benzing

III Helmsworth

Schreiber

Kaplan

Late results of reconstruction of the right ventricular outflow tract with porcine xenografts in children. Ann Thorac Surg 1981;31:437–43.

Ciaravella

McGoon

Danielson

Wallace

Mair

. Experience with the extracardiac conduit. I Thorac Cardiovasc Surg 1979;78:920–30.

Rastelli

Titus

McGoon

. Homograft of ascending aorta and aortic valve as a right ventricular outflow: An experimental approach to the repair of truncus arteriosus. Arch Surg 1967;95:698–705.

Fontan

Choussat

Deville

Doutremepuich

CDC

Coupillaud

Vosa

Aortic valve homografts in the surgical treatment of complex cardiac malformations. J Thorac Cardiovasc Surg 1984;87:649–57.

McGoon

Danielson

Puga

Ritter

Mair

Ilstrup

. Late results for congenital cardiac defects. Am J Cardiol 1982;49:1741–7.

10.

Shabbo

Wain

Ross

. Right ventricular outflow tract reconstruction with aortic homograft conduit. Analysis of the long-term results. Thorac Cardiovasc Surgeon 1980;28:21–8.