Right Ventricular Outflow Tract Reconstruction With an Allograft Conduit in Non-Ross Patients: Risk Factors for Allograft Dysfunction and Failure

Disfunção do homoenxerto pulmonar utilizado na reconstrução do trato de saída do ventrículo direito

“…The option of this service for the use of the pulmonary homograft, in such position, is based on studies that show that the aortic homograft in pulmonary position presents higher index of calcification due to its composition rich in elastin [4][5][6][7][8][9][10][11][12][13][14][15] .…”

“…The rate of homograft failure varies as per the study, being in 5 years between 10.0-40.0% 5,14 of the implanted homografts and, in 10 years, between 46.0-65.0% 4,7 .…”

“…In young people, the insertion of the homograft it is considered a risk factor for the conduit failure 4,5,8,9,12,14,15,[18][19][20][21] . The reasons for this are diverse and, among them, the accelerated growth pattern of the children, the use of homografts of smaller sizes and the immunological response exacerbate in the children.…”

“…The pulmonary homograft small in size is associated to a higher dysfunction rate and surgical exchange 4,5,14,15,18,19,[21][22][23][24] .…”

Searching for the optimal heart valve

“…Allografts have optimal hemodynamic characteristics and are resistant to infections. Disadvantages of allografts, particularly in pediatric and young adult patients (the group presented by Weimar et al [1]), include its limited availability (due to decreasing organ donations), an inability to grow, degeneration and subsequent long-term failure [4]. Potential culprits for longterm failure include immunological responses [5] and an increased calcium metabolism [6].…”