The Cryopreserved Homograft Valve in the Pulmonary Position: Early Results and Technical Considerations
| Autor: | JOHN J. LAMBERTI, WILLIAM W. ANGELL, J. DEANE WALDMAN, TODD M. GREHL, LILY GEORGE, JAMES W. MATHEWSON, STANLEY E. KIRKPATRICK, ROBERT SPICER, DEBORAH THOMSON |
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| Rok vydání: | 1988 |
| Předmět: |
Adult
Heart Defects Congenital Reoperation Pulmonary and Respiratory Medicine medicine.medical_specialty Adolescent Pulmonary insufficiency Persistent truncus arteriosus California Postoperative Complications Internal medicine medicine Humans Transplantation Homologous Ventricular outflow tract cardiovascular diseases Cardiac Surgical Procedures Child Survival rate Contraindication Aged Cryopreservation Pulmonary Valve business.industry Infant Newborn Infant Middle Aged Hospitals Pediatric medicine.disease Pulmonary hypertension Surgery Survival Rate Transplantation surgical procedures operative medicine.anatomical_structure Child Preschool Pulmonary valve cardiovascular system Cardiology Cardiology and Cardiovascular Medicine business Follow-Up Studies |
| Zdroj: | Journal of Cardiac Surgery. 3:247-251 |
| ISSN: | 1540-8191 0886-0440 |
| DOI: | 10.1111/j.1540-8191.1988.tb00245.x |
| Popis: | Since September, 1985, 20 patients have undergone implantation of a homograft valve in the pulmonary position (16 pulmonary, 4 aortic). There were 11 primary operations and 9 reoperations. In 7 of 11 primary operations the homograft valve was utilized as a composite conduit with a short Dacron extension. In four of five reoperations for a failed porcine valved conduit, a composite homograft conduit was used. Four patients underwent implantation of a free homograft in a previously repaired right ventricular outflow tract (RVOT). Age ranged from 15 days to 22 years. There was one operative death (5%), a seven-week-old infant with truncus arteriosus. Long-term follow-up ranges from 1 to 30 months. Clinical performance has been satisfactory in 18 of 19 patients. One patient undergoing free implantation of a pulmonary valve in the RVOT required replacement at 18 months with a porcine valve. In this patient, pulmonary insufficiency was caused by distortion of the annulus secondary to dilatation and pulmonary hypertension. Nine of 18 survivors do not require medication. Eleven of 18 have trivial to mild pulmonary insufficiency murmurs without symptomatology. The homograft valve is extremely useful in reconstruction of the right heart, however, early insufficiency murmurs have been noted. Distortion of the valve annulus may contribute to the early onset of a benign insufficiency murmur. Residual distal obstruction or pulmonary hypertension may be a contraindication to the use of a free homograft in the orthotopic position. |
| Databáze: | OpenAIRE |
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