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THE USE OF XENOGRAFT AND PULMONARY HOMOGRAFT IN RIGHT VENTRICLE OUTFLOW TRACT OBSTRUCTIONS
THE USE OF XENOGRAFT AND PULMONARY HOMOGRAFT IN RIGHT VENTRICLE OUTFLOW TRACT OBSTRUCTIONS
Yüksel Atay, Tahir Yağdı, Hasan Reyhanoğlu, *Hasan Güven, *Ertürk Levent, *Arif Ruhi Özyürek, Emin Alp Alayunt
Ege Üniversitesi Tıp Fakültesi, Kalp ve Damar Cerrahisi Ana Bilim Dalı, İzmir
*Ege Üniversitesi Tıp Fakültesi, Çocuk Sağlığı ve Hastalıkları Ana Bilim Dalı, İzmir
Background: This study was planned to investigate the early and mid-term results of pulmonary homografts and xenograft valved conduits in the treatment of right ventricular outflow tract (RVOT) obstruction.
Methods: Between January 1997 and July 2002, 19 patients with RVOT obstruction were operated in Ege University Medical Faculty. Pulmonary homografts, which provided from our homograft bank, were used in 9 (47.3%) patients and xenografts in 10 (52.6%) patients. Cryolife-Ross stentless porcine bioprosthesis were used in 8 patients and bovine jugular vein in 2 patients as xenografts.
Results: The hospital mortality was 21.05% in patients with RVOT obstruction treated with pulmonary valved conduits, while 30.0% (3/10) in xenograft group and 11.1% (1/9) in the homograft group. Minimal pulmonary insufficiency was detected by transthoracic echocardiography in 85.7% (6/7) of xenograft group patients and in 12.5% (1/8) of homograft group patients at mid-term follow-up (p = 0.026). Structural deterioration, calcification and obstruction in pulmonary conduits were not detected in any of the patients.
Conclusion: The performance of the right ventricle is very important to improve the survival in patients with RVOT obstructions. If there is a shortage for homografts, xenografts can be used as an alternative with reasonable early and mid-term results for a better right ventricular performance.
Keywords : Xenografts, pulmonary homografts, bovine jugular vein conduit, right ventricular outflow truct obstructions
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