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Ann Thorac Surg 2003;75:1067-1068
© 2003 The Society of Thoracic Surgeons

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Correspondence

25-year follow-up of 88 cases with homograft aortic conduits for coarctation repair: Reply

Cardiovascular Surgery Department, Semmelweis University, H-1122 Budapest, Varosmajor utca 68, Hungary

e-mail: szabzol{at}webmail.hu

To the Editor:

We are thankful to Dr Litwin for sharing the long-term results of pioneering work. Even by today’s standards the surgical results of Dr Gross’ team are outstanding. The management and operative techniques that we perform in our institution are based on his published article [1]. The tissue after homograft preparation becomes nonviable; however, this is probably not significant for aortic wall replacement. There is no evidence that maintaining cell viability during preparation and storage improves long-term results of allograft values [2]. The other similarity between Gross’ team and our group is the operating strategy. Nowadays coarctation is managed mainly in infancy by resection and end-to-end anastomosis [3]. This is easy because of elastic tissues and removes ductal remnants. In the 1950s there was a long waiting list for advanced surgical methods and some patients became adolescents. In these patients, especially when longer aortic segments are affected, resection and implantation of an interposition graft is necessary. This method produces less stress on the suture line and on the normal aortic wall. It is questionable whether commonly used prosthetic materials can provide as good long-term results as homografts. But the lesson we can learn from the follow-up of our patients is that we can expect extremely good long-term outcomes when homograft tissue is implanted.

References

1. Gross R.E. Treatment of certain aortic coarctations by homologous grafts. Ann Surg 1951;134:753-768.
2. Grunkemeier L.G., Bodnar E. Comparison of structural valve failure among different models of homograft valves. J Heart Valve Dis 1994;3:556-560.[Medline]
3. van Son J.A.M., Daniels O., Vincent J.G., et al. Appraisal of resection and end-to-end anastomosis for repair of coarctation of the aorta in infancy: preference for resection. Ann Thorac Surg 1989;48:496-502.[Abstract/Free Full Text]

This Article Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted 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 Author home page(s): Elek Bodor Zoltan Szabolcs Permission Requests Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Hüttl, T. Articles by Szabolcs, Z. Search for Related Content PubMed PubMed Citation Articles by Hüttl, T. Articles by Szabolcs, Z. Related Collections Great vessels