Long-term Outcome Of Homograft Aortic Valve In Patients Undergoing Surgical Repair Of Teralogy Of Fallot

Objective:Homograft valves are now widely used in the repair of congenital heart diseases between the right ventricle and pulmonary arteries because the valves can effectively prevent a ventricle failure due to pulmonary insufficiency or stenosis.There are two major obstacles to use vascular allograft:One is their limitedavailability and the other is their poor durability.To improve the durability andquality of homografts,we better the cryopreservation technique.The purpose of the present study is to evaluate the long effect of vascular allografts and explore the effects of the new cryopreservation technique.Method:Between 1991and 1997,78 homograft aortic valves,cryopreserved with improved technique,or pericardial patches were implanted to reconstruct the right ventricular outflow tracts in children with TOR 30 Patients with pericardial patches and 48 patients with homograft aortic valvular patches were concluded in our study. These patients meaned 6.8 6.1 years old and ranged 2.0 to 15 years old And these patients were divided into 6 groups. Group A-- homograft aortic valves and pulmonary valves function well; group B-- pericardial patches and pulmonary valves function well; group C-- homograft aortic valves , pulmonary valves exhibit a poor function; group D-- pericardial patches and pulmonary valves exhibit a poor function;group E-- homograft aortic valves and their age >4 years; group F--homograft aortic valves and their age <4 years.Examination of echocardiogram, electrocardiogram and blood pressure were simultaneously used to assess ventricular function,allograft storage time and degenerative causes of long-term survivors after total corrections of TORResult: In our studv.the leaflets were still present and not fued together 6-12years later.Calcification neither homograft aortic nor valves were found in all groups.Most homografts were functioning well while the homografts became progressively obstructive or regurgitated in the young. Young age were significantly associated with obstruction or regurgitation. However the pulmonary valves exhibit a poor function and homograft aortic valves were significantly prior to the pulmonary valves exhibit a poor function and pericardial patches in all indexes.Conclusion-. Homograft aortic valvular patches in the repair of TOF can prevent long-time postoperative pulmonary insufficiency and improve postoperative outcomes for patients. (1)To those pulmonary valves exhibit a poor function, homograft aortic valves was significantly prior to pericardial patches .(2)To those pulmonary valves function well, the effects is similar in these two groups. (3)No case shows calcification, it indicates that the new cryopreservation technique is satisfactory. (4)Young age were significantly associated with the development of >2+PR or a >40mmHg transvalvular gradient.