RESULTS OF HEART VALVE HOMOGRAFT IMPLANTATION IN A MAJOR REFERRAL CENTER IN IRAN

Abstract

Background- Heart Valve homografts have been used in reconstructions of right and ‎left ventricular outflow tract (RVOT and LVOT) for nearly 50 years now with ‎varying results. Methods- The outcome of homograft implantation was analyzed in ‎‎101 patients who received 108 cryopreserved homografts for the reconstruction of ‎RVOT and LVOT between April 1993 and March 2003‎‏.‏ Results- 88.2% aortic valve and 11.7% pulmonic valve homografts were used. ‎Median age at implantation was 10.0 years (Mean: 13.1 ± 10.6 years, range: 5 months ‎to 57 years). Endpoints included: (1) patient survival, (2) homograft failure (valve ‎explant or late death) and (3) homograft dysfunction (homograft insufficiency or ‎homograft stenosis). Mean follow up duration was 2.9 ± 2.4 years. There were 11 ‎homograft dysfunctions requiring reoperation with the mean longevity of 4.4 ± 2.3 ‎years. We had only one late death due to congestive heart failure (CHF), and all the ‎other deaths (23.7% of the patients) occurred perioperatively. The quality of life of ‎most of the survivors is good‏.‏ Conclusion- Early and mid-term results of homograft implantation are good, but long-‎term results remain to be investigated (Iranian Heart Journal 2003; 4 (4):6-15‎‏).