Mid-term Outcomes for the Application of Homograft Valve Conduits in Right Ventricular Outflow Reconstruction in Patients With Congenital Heart Disease / 中国循环杂志

ABSTRACT

Objective: To evaluate mid-term outcomes for the application of homograft valve conduits in right ventricular outlfow reconstruction in patients with congenital heart disease. Methods: We retrospectively studied 122 patients who received right ventricular outlfow reconstruction by homograft valve conduits application in our hospital from 2007-10 to 2014-07. The patients were divided into different sets of groups, by surgical procedure Ross group,n=38 and Non-Ross group,n=84; by median age ≤6 years group,n=61 and >6 years group, n=61; by the type of valve conduits Aortic homograft group,n=21 and Pulmonary homograft group,n=101; by the diameter of conduits ≤19 mm group,n=31 and >19 mm group,n=91. The relationships between pre-operative conditions, different types of conduits and diameters to the prognosis were analyzed; the post-operative death, re-operation, free homograft valve conduits failure rates were followed-up in all patients. Results: The average follow-up time was (35.4 ± 22.2) months and 2/122 (1.6%) patients died during that period, the overall free conduits failure rates at 1, 5 and 7 years post-operation were 94.2%, 81.2% and 75.4% respectively. The free conduits failure rates in Pulmonary homograft group at 1, 5, 7 years post-operation were 96.2%, 86.1%,79.9% and in Aortic homograft group were 80.0%, 59.7%, 59.7% respectively,P=0.011; in Ross group were 96.4%, 89.0%, 89.0% and in Non-Ross group were 91.3%, 78.3%, 67.1% respectively,P=0.045. While the age, conduits diameter, cyanosis and re-operation had no statistical meaning to free conduits failure rates, allP>0.05. Conclusion: Application of homograft valve conduits had good mid-term outcomes in right ventricular outflow reconstruction in patients with congenital heart disease, while the long-term effects should be further emphasized in clinical practice.