Long-term results of homograft valves in extracardiac conduits. 1989

R S Almeida, and R K Wyse, and M R de Leval, and M J Elliott, and J Stark
Cardiothoracic Unit, Hospital for Sick Children, London, UK.

Between 1971 and 1986, 335 patients received various extracardiac valved conduits between one of the heart chambers and the pulmonary arteries. The group of patients who received aortic homograft conduits and survived the operation were analysed in detail. The age varied between 9 days and 18 years (mean 7.1 +/- 0.7 years), weight 2.4 kg-63.5 kg (mean 17.8 +/- 10.8 kg). The diameter of the conduit used was 10-30 mm (mean 20.8 mm). Multivariate analysis revealed a highly significant model (P less than 0.005) which showed that the time interval between harvesting and use of the homograft (P less than 0.02) and the earlier date of operation (P less than 0.05) were the major risk factors for obstruction. Homografts used within 3 weeks of harvesting had freedom from obstruction of 79% at 8 years; homografts used between 3-6 weeks had freedom from obstruction of only 55% at 8 years. Homografts used alone performed significantly better than those extended with woven Dacron tubes. At 10 years, 93% of homografts used alone were free of obstruction compared to 52% of homografts extended with a Dacron tube. We conclude that aortic homografts used within 3 weeks of harvesting provide a reasonably durable conduit for a period of 12 years. Longer storage, and extension of the homograft with a woven Dacron tube should be avoided.

UI MeSH Term Description Entries
D007223 Infant A child between 1 and 23 months of age. Infants
D007231 Infant, Newborn An infant during the first 28 days after birth. Neonate,Newborns,Infants, Newborn,Neonates,Newborn,Newborn Infant,Newborn Infants
D011183 Postoperative Complications Pathologic processes that affect patients after a surgical procedure. They may or may not be related to the disease for which the surgery was done, and they may or may not be direct results of the surgery. Complication, Postoperative,Complications, Postoperative,Postoperative Complication
D012086 Reoperation A repeat operation for the same condition in the same patient due to disease progression or recurrence, or as followup to failed previous surgery. Revision, Joint,Revision, Surgical,Surgery, Repeat,Surgical Revision,Repeat Surgery,Revision Surgery,Joint Revision,Revision Surgeries,Surgery, Revision
D002648 Child A person 6 to 12 years of age. An individual 2 to 5 years old is CHILD, PRESCHOOL. Children
D002675 Child, Preschool A child between the ages of 2 and 5. Children, Preschool,Preschool Child,Preschool Children
D005500 Follow-Up Studies Studies in which individuals or populations are followed to assess the outcome of exposures, procedures, or effects of a characteristic, e.g., occurrence of disease. Followup Studies,Follow Up Studies,Follow-Up Study,Followup Study,Studies, Follow-Up,Studies, Followup,Study, Follow-Up,Study, Followup
D006083 Graft Occlusion, Vascular Obstruction of flow in biological or prosthetic vascular grafts. Graft Restenosis, Vascular,Vascular Graft Occlusion,Vascular Graft Restenosis,Graft Restenoses, Vascular,Occlusion, Vascular Graft,Restenosis, Vascular Graft
D006349 Heart Valve Diseases Pathological conditions involving any of the various HEART VALVES and the associated structures (PAPILLARY MUSCLES and CHORDAE TENDINEAE). Heart Valvular Disease,Valvular Heart Diseases,Disease, Heart Valvular,Heart Disease, Valvular,Heart Valve Disease,Heart Valvular Diseases,Valve Disease, Heart,Valvular Disease, Heart,Valvular Heart Disease
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man

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