We have been used cryopreserved homograft valves for right ventricular outflow tract (RVOT) reconstruction since November 1993. The homograft valves were harvested from the hearts of brain dead patients or hearts of transplant recipients.
There were 12 male and 10 female patients. Their ages ranged from 5 months to 13 years (mean age, 39.2*37.4 months) and the weight ranged from 5 to 48kg (mean weight, 13.7*9.1 kg).
The diagnoses included pulmonary atresia with ventricular septal defect (n=14), tetralogy of Fallot (n=4), truncus arteriosus (n=3), and double outlet right ventricle with pulmonic stenosis (n=1). Monocuspid homograft patches were used for RVOT
widening
or REV (reparation l'etage ventriculaire) operations in 4 patients. We also used homograft as valved conduits for RVOT reconstruction in 17 patients and left ventricular outflow tract reconstruction in anatomically corrected transposition in 1
patient.
Among them size-reducing technique (converting a tricuspid valved conduit into a bicuspid valved conduit) were applied to six patients for the correction of size mismatching.
The mean follow-up period was 10.6*5.4 months. There was one operative death (4.5%) due to bleeding and one reoperation for removal of vegetation on the homograft leaflet. Postoperative echocardiography documented no significant homograft
insufficiency
and RVOT obstructions.
In short-term, the homograft valves provide excellent hemodynamic characteristics, even though further studies are necessary to evaluate the long-term results.
(Korean J Thoracic Cardiovas Sung 1995;28:1038-44)
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