Evaluation of downsized homograft conduits for right ventricle-to-pulmonary artery reconstruction

McMullan, DM, Oppido, G, Alphonso, N, Cochrane, AD, d'Acoz, YD and Brizard, CP (2006) Evaluation of downsized homograft conduits for right ventricle-to-pulmonary artery reconstruction. Journal of Thoracic and Cardiovascular Surgery, 132 1: 66-71. doi:10.1016/j.jtcvs.2006.02.041

Author McMullan, DM
Oppido, G
Alphonso, N
Cochrane, AD
d'Acoz, YD
Brizard, CP
Title Evaluation of downsized homograft conduits for right ventricle-to-pulmonary artery reconstruction
Journal name Journal of Thoracic and Cardiovascular Surgery   Check publisher's open access policy
ISSN 0022-5223
Publication date 2006
Sub-type Article (original research)
DOI 10.1016/j.jtcvs.2006.02.041
Open Access Status
Volume 132
Issue 1
Start page 66
End page 71
Total pages 6
Language eng
Subject 2705 Cardiology and Cardiovascular Medicine
2746 Surgery
Abstract Objective: Although homograft conduits are frequently used to establish right ventricle-to-pulmonary artery continuity, the limited availability of small-size homografts is a significant constraint in pediatric cardiac surgery. We compared the performance of standard homograft conduits with that of surgically reduced bicuspid homograft conduits in patients undergoing repair of truncus arteriosus. Methods: Forty infants undergoing complete repair of truncus arteriosus with either standard homografts (n = 26) or reduced-size bicuspid homografts (n = 14) were evaluated. Results: The median downsized conduit diameter (13 mm) was similar to the standard homograft diameter (12 mm, P = .52). There were 6 early deaths and 5 late deaths, representing an overall 30-day mortality of 15% and a 5-year mortality of 25%. No deaths were directly related to homograft dysfunction. Four (29%) downsized conduits and 8 (31%) standard conduits required replacement at a median interval of 18.5 months and 42.4 months, respectively. Catheter-based interventions were required in 5 (36%) patients in the downsized group and in 3 (12%) patients in the standard group. There was no difference in freedom from surgical or catheter-based reintervention between the 2 groups (P = .42). Freedom from conduit failure (severe conduit stenosis, moderate or greater regurgitation) was 55.9% and 17.2% at 3 years in the downsized and standard groups, respectively. Conclusion: The surgically downsized homograft is an excellent option when an appropriate-sized homograft is not available and might prevent morbidity associated with the use of an oversized conduit.
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status Unknown

Document type: Journal Article
Sub-type: Article (original research)
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