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- W2003644843 abstract "Objectives: Small-sized homografts are rare but required for reconstruction of the right ventricular outflow tract (RVOT). Downsizing adult-sized homografts may be an option to overcome this shortage of availability. Methods: Since 1994 we bicuspidalised adult-sized homografts by excising one cusp. The aim of this study was to analyse the durability of bicuspidalised homografts and compare it to small-sized homografts in a paediatric population. All patients below 14 kg of body weight were included in the study. The endpoint of the study was explantation of the homograft. Results: The study population consisted of 144 patients, 78 (54%) receiving a bicuspidalised homograft. Median age was 17.7 (0.3–64.8) months and mean weight 8.6 ± 3.3 kg. Mean homograft size was 14.8 ± 2.4 mm and mean z-score was 1.5 ± 0.9. Median follow-up time was 10 years (0.03–19.7). There were no differences between patients receiving a bicuspidalised homograft and a small-sized homograft regarding demographic data, operative data and diagnoses. Freedom from homograft explantation was 94.6 ± 2.6%, 85.9 ± 4.2% and 64.2 ± 6.6% for bicuspidalised homografts compared to 92.2 ± 3.3%, 76.2 ± 5.6% and 59.1 ± 6.9% for non-bicuspidalised homografts at 1, 5 and 10 years, respectively (P = 0.3). Risk factors for homograft explantation in the multivariate analysis were a homograft z-score <1 and age below 1 year at time of implantation (P = 0.02). Conclusion: Bicuspidalisation of homografts results in a similar durability compared to small-sized homografts. Therefore, downsizing adult-sized homografts and creation of a bicuspidalised valvar mechanism to fit into the corresponding RVOT in children with congenital heart defects is an excellent method to overcome the shortage of small-sized homografts." @default.
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- W2003644843 date "2014-09-23" @default.
- W2003644843 modified "2023-10-16" @default.
- W2003644843 title "109-I * DURABILITY OF BICUSPIDALISED HOMOGRAFTS FOR THE RECONSTRUCTION OF THE RIGHT VENTRICULAR OUTFLOW TRACT" @default.
- W2003644843 doi "https://doi.org/10.1093/icvts/ivu276.109" @default.
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