Results of large pulmonary homograft implantation for right ventricular outflow tract reconstruction

Abstract

Background : To evaluate the long-term results of implantation of homogeneous large size of pulmonary homograft (PH) for reconstruction of the right ventricular outflow tract (RVOT). Methods : Between January 2000 and December 2017, 107 patients were implanted with PH for reconstruction of the RVOT. Data were collected retrospectively in this single-center study. PH failure was defined as a peak of gradient > 40 mmHg and/or as a pulmonary regurgitation > grade 2. Primary endpoint was the re-operation of the RVOT during follow-up. Secondary endpoints were overall survival, occurrence of PH failure and the rate of re-operation for all cause. Results : Mean age of the recipients was 26.13 ? 13.59 years. Mean size of PH was 23.02 ? 6.87 mm. Re-operation of the RVOT occurred in 8 patients (7.8%). Time before re-operation was 2.74 years (Interquartile Range: 6.41). Freedom from re-operation for RVOT at 5 and 10 years was respectively 95.7% and 90.0%. Overall survival at 10 years was 95.2%. PH failure occurred in 13 patients (12.0%). Mean time before PH failure was 5.00 ? 4.35 years. Freedom from PH failure at 10 years was 81.6%. Re-operation for PH failure occurred in 4 patients (3.9%). Concomitant tricuspid valve surgery (p=0.037), initial pulmonary stenosis (p=0.04), recipient of PH < 16 years old (p=0.043) were risk factors of late reoperation in univariate analysis. Multivariate analysis showed no independent risk factor of late reoperation. Conclusions : Implantation of large PH for RVOT reconstruction provides excellent mid-term results in terms of re-operation.Results of large pulmonary homograft implantation for right ventricular outflow tract reconstruction Pulmonary homograft as right outflow tract

Letter to the Editor: Results of large pulmonary homograft implantation for right ventricular outflow tract (RVOT) reconstruction

“…Follow-up care for all patients is excluded. 1 The sample size is too small to generalize to the population. A study was conducted in Sweden with a larger sample size from various regions.…”

“…To the Editor, We read the article "Results of large pulmonary homograft implantation for right ventricular outflow tract (RVOT) reconstruction" enthusiastically. A retrospective cohort study by Simon Dang Van et al, 1 reveals a significant association between obesity and mortality. This article was a pleasure to read, and the author's effort is admirable.…”