Pulmonary homograft: should it be used in the aortic position?
J Thorac Cardiovasc Surg
; 120(1): 148-55, 2000 Jul.
Article
en En
| MEDLINE
| ID: mdl-10884668
ABSTRACT
OBJECTIVE:
Retrospective analysis was performed to determine the suitability of pulmonary homograft as an aortic valve substitute.METHODS:
From January 1994 through June 1999, 147 patients (mean age, 32.2 +/- 17.3 years) underwent aortic valve replacement with either an aortic homograft (group 1 n = 103, 25 fresh antibiotic preserved and 78 cryopreserved) or a pulmonary homograft (group 2 n = 44, 11 antibiotic preserved and 33 cryopreserved). In group 1 a scalloped subcoronary technique was used in 64 patients, and a root replacement technique was used in 39 patients. In group 2 the scalloped subcoronary technique was used in 34 patients, and the root replacement technique was used in 10 patients.RESULTS:
There were 131 operative survivors (group 1 = 91; group 2 = 40). Follow-up ranged from 2 to 62 months. In group 1 none of the patients had significant aortic regurgitation during the hospital stay. Three patients (all having undergone the scalloped subcoronary technique) had moderate aortic regurgitation after 6 to 32 months. In group 2, 10 patients (9 having undergone the scalloped subcoronary technique and 1 having undergone the root replacement technique) developed significant regurgitation 2 intraoperatively, 5 in the early postoperative period before discharge from the hospital, and 3 during late follow-up 6 to 12 months postoperatively. Among the various risk factors analyzed for overall homograft failure, use of a pulmonary homograft was the single independent predictor of valve failure (odds ratio, 8.6; 95% confidence interval, 1.9-39; P =.006).CONCLUSION:
Pulmonary homograft, when inserted by means of a scalloped subcoronary technique, is not a suitable aortic valve substitute.
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Banco de datos:
MEDLINE
Asunto principal:
Válvula Aórtica
/
Válvula Pulmonar
Tipo de estudio:
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Límite:
Adolescent
/
Adult
/
Aged
/
Child
/
Child, preschool
/
Female
/
Humans
/
Male
/
Middle aged
Idioma:
En
Año:
2000
Tipo del documento:
Article