Evaluation of 188 consecutive homografts implanted in pulmonary position after 20 years☆☆☆

Boethig, Dietmar; Goerler, Heidi; Westhoff-Bleck, Mechthild; Ono, Masamichi; Daiber, Anna; Haverich, Axel; Breymann, Thomas

doi:10.1016/j.ejcts.2007.02.025

Cited by 100 publications

(70 citation statements)

References 24 publications

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“…Thus, because the patients are still operated in the first year of life, the use of a valve mechanism needs to solve the problems of durability (which are growth and the absence of degeneration) [18][19].…”

Section: Discussionmentioning

confidence: 99%

Emprego e avaliação em médio prazo da cúspide de homoenxerto decelularizado na correção da tetralogia de Fallot

Mulinari¹,

Navarro

Pimentel

et al. 2008

Rev Bras Cir Cardiovasc

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Section: Discussionmentioning

confidence: 99%

Emprego e avaliação em médio prazo da cúspide de homoenxerto decelularizado na correção da tetralogia de Fallot

Mulinari¹,

Navarro

Pimentel

et al. 2008

Rev Bras Cir Cardiovasc

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“…W wyniku zmian degeneracyjnych doszło do dysfunkcji homograftu z powstaniem istotnego zwężenia i niedomykalności płucnej. Taka historia naturalna po tego rodzaju korekcjach jest typowa [4,5], a pacjenci ci wymagają kolejnych (piątej w przypadku opisywanego pacjenta) reoperacji. Nieoperacyjne wszczepienie zastawki biologicznej może obecnie stanowić alternatywną opcję terapeutyczną [1-3, 6, 7].…”

Section: Dyskusjaunclassified

Is the “porcellain homograft” a contraindication for transcatheter pulmonary valve implantation? A

Demkow¹,

Rużyłło²,

Biernacka³

et al. 2011

pwki

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S t r e s z c z e n i ePrzeznaczyniowa implantacja zastawki płucnej jest nową metodą leczenia chorych ze złożonymi wrodzonymi wadami serca, u których po operacyjnej rekonstrukcji drogi odpływu prawej komory doszło do zwężenia lub niedomykalności zastawki pnia płucnego. Najlepszymi kandydatami do zabiegu są chorzy z homograftem płucnym lub innym pełnym konduitem w drodze odpływu prawej komory. W pracy opisano pacjenta po rekonstrukcji drogi odpływu prawej komory za pomocą homograftu aortalnego, u którego wystąpiło powikłanie w trakcie zabiegu nieoperacyjnego wszczepienia zastawki płucnej.Słowa kluczowe: przeznaczyniowe wszczepienie zastawki, zastawka płucna, homograft aortalny, płucny, pęknięcie homograftu A b s t r a c t A male patient had a repeat surgical right ventricular outflow reconstruction with the aortic homograft, for pulmonary atresia at the age of 7 years. At the age of 17 a homograft dysfunction (with predominant stenosis) developed and he was admitted for transcatheter pulmonary valve implantation. Severe calcifications of the total homograft wall were recognized. A homograft rupture with contrast extravasation to the mediastinal space occurred at the superior margin of the stent implanted for valve presenting. A covered stent was implanted to cover the leak, but this resulted in a second homograft rupture at the distal margin of the stent. The extravasation was estimated to be small and stable, and a Melody pulmonary valve was successfully implanted on a 20 mm system. Repeat planned angiography 4 days after the procedure revealed significant enlargement of the pseudoaneurysm and the patient was sent for surgery. Right ventricular outflow was uneventfully reconstructed with a pulmonary homograft. Excised old aortic homograft walls had an eggshell appearance. We suggest that a "porcelain" aortic homograft should be a contraindication for transcatheter pulmonary valve implantation.

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“…The higher dysfunction rate in our study was for a Z value below zero and above plus three, that is, the best results were obtained when the size of the pulmonary valva was between zero and plus three Z value. Thus, some centers, including our Service, has been using a homograft with the biggest number possible for the children, trying to compensate the natural growth of them with a valva of biggest size and decrease the incidence of dysfunction and surgical exchange 7,14,20,21,25,26 .…”

Section: Graph 2 -Relation Of the Z Score Value Of The Pulmonary Valvmentioning

confidence: 99%

“…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.…”

Section: Graph 2 -Relation Of the Z Score Value Of The Pulmonary Valvmentioning

confidence: 99%

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

Lenzi¹,

Olandoski²,

Ferreira³

et al. 2011

Arq. Bras. Cardiol.

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show abstract

Evaluation of 188 consecutive homografts implanted in pulmonary position after 20 years☆☆☆

Abstract: Homograft implantation in the pulmonary position can be performed with good long-term freedom from explantation. However, freedom from degeneration is a matter of concern. Therefore, alternative valved conduits are required especially for pediatric patients.

Cited by 100 publications

References 24 publications

Emprego e avaliação em médio prazo da cúspide de homoenxerto decelularizado na correção da tetralogia de Fallot

Emprego e avaliação em médio prazo da cúspide de homoenxerto decelularizado na correção da tetralogia de Fallot

Is the “porcellain homograft” a contraindication for transcatheter pulmonary valve implantation? A

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

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