The Cryopreserved Homograft Valve in the Pulmonary Position: Early Results and Technical Considerations

JOHN J. LAMBERTI, WILLIAM W. ANGELL, J. DEANE WALDMAN, TODD M. GREHL, LILY GEORGE, JAMES W. MATHEWSON, STANLEY E. KIRKPATRICK, ROBERT SPICER, DEBORAH THOMSON

Research output: Contribution to journalArticle

8 Citations (Scopus)

Abstract

Since September, 1985, 20 patients have undergone implantation of a homograft valve in the pulmonary position (16 pulmonary, 4 aortic). There were 11 primary operations and 9 reoperations. In 7 of 11 primary operations the homograft valve was utilized as a composite conduit with a short Dacron extension. In four of five reoperations for a failed porcine valved conduit, a composite homograft conduit was used. Four patients underwent implantation of a free homograft in a previously repaired right ventricular outflow tract (RVOT). Age ranged from 15 days to 22 years. There was one operative death (5%), a seven‐week‐old infant with truncus arteriosus. Long‐term follow‐up ranges from 1 to 30 months. Clinical performance has been satisfactory in 18 of 19 patients. One patient undergoing free implantation of a pulmonary valve in the RVOT required replacement at 18 months with a porcine valve. In this patient, pulmonary insufficiency was caused by distortion of the annulus secondary to dilatation and pulmonary hypertension. Nine of 18 survivors do not require medication. Eleven of 18 have trivial to mild pulmonary insufficiency murmurs without symptomatology. The homograft valve is extremely useful in reconstruction of the right heart, however, early insufficiency murmurs have been noted. Distortion of the valve annulus may contribute to the early onset of a benign insufficiency murmur. Residual distal obstruction or pulmonary hypertension may be a contraindication to the use of a free homograft in the orthotopic position.

Original languageEnglish (US)
Pages (from-to)247-251
Number of pages5
JournalJournal of Cardiac Surgery
Volume3
Issue number3
DOIs
StatePublished - Sep 1988

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Pulmonary Valve
Allografts
Reoperation
Pulmonary Hypertension
Lung
Swine
Truncus Arteriosus
Polyethylene Terephthalates
Survivors
Dilatation

ASJC Scopus subject areas

  • Surgery
  • Cardiology and Cardiovascular Medicine

Cite this

LAMBERTI, JOHN. J., ANGELL, WILLIAM. W., WALDMAN, J. DEANE., GREHL, TODD. M., GEORGE, LILY., MATHEWSON, JAMES. W., ... THOMSON, DEBORAH. (1988). The Cryopreserved Homograft Valve in the Pulmonary Position: Early Results and Technical Considerations. Journal of Cardiac Surgery, 3(3), 247-251. https://doi.org/10.1111/j.1540-8191.1988.tb00245.x

The Cryopreserved Homograft Valve in the Pulmonary Position : Early Results and Technical Considerations. / LAMBERTI, JOHN J.; ANGELL, WILLIAM W.; WALDMAN, J. DEANE; GREHL, TODD M.; GEORGE, LILY; MATHEWSON, JAMES W.; KIRKPATRICK, STANLEY E.; SPICER, ROBERT; THOMSON, DEBORAH.

In: Journal of Cardiac Surgery, Vol. 3, No. 3, 09.1988, p. 247-251.

Research output: Contribution to journalArticle

LAMBERTI, JOHNJ, ANGELL, WILLIAMW, WALDMAN, JDEANE, GREHL, TODDM, GEORGE, LILY, MATHEWSON, JAMESW, KIRKPATRICK, STANLEYE, SPICER, ROBERT & THOMSON, DEBORAH 1988, 'The Cryopreserved Homograft Valve in the Pulmonary Position: Early Results and Technical Considerations', Journal of Cardiac Surgery, vol. 3, no. 3, pp. 247-251. https://doi.org/10.1111/j.1540-8191.1988.tb00245.x
LAMBERTI JOHNJ, ANGELL WILLIAMW, WALDMAN JDEANE, GREHL TODDM, GEORGE LILY, MATHEWSON JAMESW et al. The Cryopreserved Homograft Valve in the Pulmonary Position: Early Results and Technical Considerations. Journal of Cardiac Surgery. 1988 Sep;3(3):247-251. https://doi.org/10.1111/j.1540-8191.1988.tb00245.x
LAMBERTI, JOHN J. ; ANGELL, WILLIAM W. ; WALDMAN, J. DEANE ; GREHL, TODD M. ; GEORGE, LILY ; MATHEWSON, JAMES W. ; KIRKPATRICK, STANLEY E. ; SPICER, ROBERT ; THOMSON, DEBORAH. / The Cryopreserved Homograft Valve in the Pulmonary Position : Early Results and Technical Considerations. In: Journal of Cardiac Surgery. 1988 ; Vol. 3, No. 3. pp. 247-251.
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