Original article: cardiovascularCryopreserved homografts in the pulmonary position: determinants of durability
Section snippets
Material and methods
One hundred eighty-five cryopreserved homografts were implanted in the pulmonary position at our institution between September 1985 and January 1999. These 185 implants form the basis for the subsequent analysis. This population includes homografts placed in an orthotopic position as well as onto the right ventricular free wall. A hood of autologous pericardium or prosthetic material was used to augment the anastomosis between the ventricular wall and the homograft.
On the basis of hypothesized
Results
Table 1 demonstrates that only primary implants for predominantly non-Ross procedure indications were performed in group 1 (n = 53). In contrast, group 2 (n = 46) contained an almost equivalent number of primary homograft implants (n = 26) and conduit changes (n = 20). More than half of group 3 (n = 86) were primary Ross procedure implants (n = 48), Of note, 11 of the 14 primary implants in the tetralogy of Fallot patients of group 3 were orthotopic pulmonary valve replacements for late
Comment
Previous analyses of pulmonary position cryopreserved homograft durability have reported variable results 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12. The current study seeks to address this variability on several levels. First, pulmonary position homografts are presently used in a wide range of procedures on patients of all ages and sizes. We sought to deal with this heterogeneity by dividing the entire study population into three patient age groups. The data in Table 1 and Figure 1 support the
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