HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Kay, P. H. Articles by Ross, D. N. Search for Related Content PubMed PubMed Citation Articles by Kay, P. H. Articles by Ross, D. N.

The Annals of Thoracic Surgery, Vol 40, 360-364, Copyright © 1985 by The Society of Thoracic Surgeons

ARTICLES

Fifteen years' experience with the aortic homograft: the conduit of choice for right ventricular outflow tract reconstruction

PH Kay and DN Ross

Ninety-seven patients with pulmonary atresia underwent right ventricular outflow tract reconstruction using a homograft conduit. There were 46 hospital deaths (47%). Hospital mortality was significantly related to irreversible pulmonary hypertension (p less than 0.001) and thoracotomy for ligation of bronchial collaterals (p less than 0.01). The actuarial survival was 37 +/- 7% at 10 years. Sixteen patients undergoing recatheterization at a mean of 6 years had a mean transconduit gradient of 24 +/- 15 mm Hg. Obstructed conduits (i.e., with a gradient of greater than 50 mm Hg) were replaced in 3 patients, corresponding to 13 +/- 8% at 10 years. In each instance, the obstruction was due to neointimal hyperplasia in the Dacron tube rather than calcification of the homograft valve. The fresh, antibiotic- sterilized aortic homograft is the conduit of choice for right ventricular outflow tract reconstruction. The valve itself appears more resistant to calcification than its xenograft counterpart, and the absence of Dacron removes the problem of fibrinous peel obstructing the conduit. We now construct a tube of autologous pericardium to increase the length of the conduit and avoid complementary thoracotomy for ligation of bronchial collaterals.

This article has been cited by other articles:

				N. Sekarski, H. van Meir, M. E.B. Rijlaarsdam, P. H. Schoof, D. R. Koolbergen, J. Hruda, L. K. von Segesser, E. J. Meijboom, and M. G. Hazekamp Right Ventricular Outflow Tract Reconstruction With the Bovine Jugular Vein Graft: 5 Years' Experience With 133 Patients Ann. Thorac. Surg., August 1, 2007; 84(2): 599 - 605. [Abstract] [Full Text] [PDF]

				E. S. Selamet Tierney, W. M. Gersony, K. Altmann, D. E. Solowiejczyk, L. M. Bevilacqua, C. Khan, E. Krongrad, R. S. Mosca, J. M. Quaegebeur, and H. D. Apfel Pulmonary position cryopreserved homografts: Durability in pediatric Ross and non-Ross patients J. Thorac. Cardiovasc. Surg., August 1, 2005; 130(2): 282 - 286. [Abstract] [Full Text] [PDF]

				H. Javadpour, D. Veerasingam, and A.E. Wood Calcification of homograft valves in the pulmonary circulation -- is it device or donation related? Eur. J. Cardiothorac. Surg., July 1, 2002; 22(1): 78 - 81. [Abstract] [Full Text] [PDF]

				T. Breymann, W.-R. Thies, D. Boethig, R. Goerg, U. Blanz, and R. Koerfer Bovine valved venous xenografts for RVOT reconstruction: results after 71 implantations Eur. J. Cardiothorac. Surg., April 1, 2002; 21(4): 703 - 710. [Abstract] [Full Text] [PDF]

				S. M. Marianeschi, G. M. Iacona, F. Seddio, R. F. Abella, C. Condoluci, A. Cipriani, F. S. Iorio, S. Gabbay, and C. F. Marcelletti Shelhigh No-React porcine pulmonic valve conduit: a new alternative to the homograft Ann. Thorac. Surg., February 1, 2001; 71(2): 619 - 623. [Abstract] [Full Text] [PDF]

				S. Conte, R. Jashari, B. Eyskens, M. Gewillig, M. Dumoulin, and W. Daenen Homograft valve insertion for pulmonary regurgitation late after valveless repair of right ventricular outflow tract obstruction Eur. J. Cardiothorac. Surg., February 1, 1999; 15(2): 143 - 149. [Abstract] [Full Text] [PDF]

				K. Niwaya, C. J. Knott-Craig, M. M. Lane, K. Chandrasekaren, E. D. Overholt, and R. C. Elkins CRYOPRESERVED HOMOGRAFT VALVES IN THE PULMONARY POSITION: RISK ANALYSIS FOR INTERMEDIATE-TERM FAILURE J. Thorac. Cardiovasc. Surg., January 1, 1999; 117(1): 141 - 147. [Abstract] [Full Text] [PDF]

				J. Stark, C. Bull, M. Stajevic, M. Jothi, M. Elliott, and M. d. Leval Fate Of Subpulmonary Homograft Conduits: Determinants Of Latehomograft Failure J. Thorac. Cardiovasc. Surg., March 1, 1998; 115(3): 506 - 516. [Abstract] [Full Text]

				R. J. Baskett, D. B. Ross, M. A. Nanton, and D. A. Murphy FACTORS IN THE EARLY FAILURE OF CRYOPRESERVED HOMOGRAFT PULMONARY VALVES IN CHILDREN: PRESERVED IMMUNOGENICITY? J. Thorac. Cardiovasc. Surg., November 1, 1996; 112(5): 1170 - 1179. [Abstract] [Full Text]

				M. Ando, Y. Imai, S. Hoshino, and K. Ishihara Autologous Reconstruction of Pulmonary Trunk at Reoperation After Extracardiac Conduit Repair Ann. Thorac. Surg., March 1, 1995; 59(3): 621 - 625. [Abstract] [Full Text]

				K. Bando, G. K. Danielson, H. V. Schaff, D. D. Mair, P. R. Julsrud, and F. J. Puga Outcome of pulmonary and aortic homografts for right ventricular outflow tract reconstruction J. Thorac. Cardiovasc. Surg., March 1, 1995; 109(3): 509 - 518. [Abstract] [Full Text]

				M. A. Salim, T. G. DiSessa, B. S. Alpert, K. L. Arheart, W. M. Novick, and D. C. Watson Jr The Fate of Homograft Conduits in Children With Congenital Heart Disease: An Angiographic Study Ann. Thorac. Surg., January 1, 1995; 59(1): 67 - 73. [Abstract] [Full Text]

				S. Nakayama, T. Ban, and Y. Okamoto Fetal bovine serum is not necessary for the cryopreservation of aortic valve tissues J. Thorac. Cardiovasc. Surg., September 1, 1994; 108(3): 583 - 586. [Abstract] [Full Text]

				T. Sarioglu, T. Paker, A. Sarioglu, O. Bayindir, A. Koner, and A. Aytac Use of Non-Valved Extracardiac Conduits in Complex Congenital Anomalies Vascular and Endovascular Surgery, November 1, 1991; 25(9): 702 - 707. [Abstract] [PDF]