Purpose: The purpose of this study was to examine the longterm results of downsizing cryopreserved homograft valved conduits used in the pulmonary position for surgical correction of congenital heart defects.
Materials and Methods: We made a bicuspid valved conduit by excising a complete cusp together with a longitudinal strip of the arterial wall of adult valved conduit. Between November 1994 and November 2008, 24 patients underwent surgical reconstruction for congenital heart defects using downsizing cryopreserved homograft valved conduit implantation in pulmonary position. There were 16 males and 8 females, and the median age was 3.5 years (range, 1.3-9.3 years). There were 17 aortic homografts and 7 pulmonary homografts. Diagnosis included VSD with pulmonary atresia (n=9), D-TGA with VSD and PS (n=2), corrected-TGA (n=6), and DORV (n=2).
Results: Three patients died early after operation (12.5%). The mean follow-up period for 21 survival patients was 10.1+0.9 years (range, 8.5-11.6 years). Six patients (29%) underwent reoperation for graft failure including 5 aortic homografts and 1 pulmonary homograft. Average time to reoperation was 6.3 years (range, 5.3-8 years). There was no late death.
Conclusion: Downsizing cryopreserved homograft valved conduit function satisfactorily in the pulmonary position at longterm follow-up. The pulmonary homograft valved conduit appears to be more durable and less calcification than the aortic homograft valved conduit in the pulmonary position.