Factors influencing the survival of cryopreserved homografts. The second homograft performs as well as the first
- 作者：Bart Meyns ; Ramadan Jashari ; Marc Gewillig ; Luc Mertens ; Arnoš ; t Komá ; rek ; Emmanuel Lesaffre ; Werner Budts and Willem Daenen
- 关键词：Congenital heart surgery ; Biological heart valve ; Allograft
- 刊名：European Journal of Cardio-Thoracic Surgery
- 出版年：2005
- 期刊代码：89_10107940
- 类别：med
- 出版时间：2005
- 卷：28
- 期：2
- 页码：211-216
- 文件大小：179 K
摘要
Objective: To determine the life span of cryopreserved homografts implanted in the right ventricular outflow tract and the factors influencing it. Methods: From 1989 through 2003, we reconstructed the pulmonary valve with 301 homografts in 272 patients (median age 13 years; range 4 days–69 years). Indications were tetralogy of Fallot (136), truncus (23), Rastelli repair (11), double outlet ventricle (13), endocarditis (5), and the Ross operation (84). Median follow-up was 5.7 years (range 0–14). We analyzed possible predictors of graft replacement by simple and multiple Cox regression. Results: Actuarial survival was 96±1.2%at 1, 95±1.4%at 5, and 94±1.5%at 10 years follow-up. Three homografts were explanted because of endocarditis (excluded from the analysis). Freedom from explantation was 99.6±0.4%at 1, 94.5±1.7%at 5, and 81.8±4.1%at 10 years. Variables, significantly related to explantation in the univariate analysis, were younger age, small graft size, implantation in a non-anatomical position, the aortic donor homograft, a shorter aortic cross-clamp time and the implantation of a second homograft. In the multiple model, non-anatomical position (P