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Iranian homograft heart valves: assessment of durability and late outcome.
- Source :
-
Cell and tissue banking [Cell Tissue Bank] 2016 Dec; Vol. 17 (4), pp. 603-610. Date of Electronic Publication: 2016 Aug 08. - Publication Year :
- 2016
-
Abstract
- Durability and the rate of complications of homograft heart valves, adjusted for patient-related contributors and surgical techniques, rely mainly on the quality of allografts which in turn are mirrored in the donor characteristics and most importantly recovery and processing procedures. Aimed to assess the quality, a study was conducted to figure out the durability and late outcome following homograft replacement with valved conduits procured by the Iranian Tissue Bank. Retrospectively, the pre-implantation, perioperative and follow-up data of 400 non-consecutive recipients of cryopreserved heart valves (222 pulmonary and 178 aortic) from 2006 to 2015 were collected and analyzed in terms of variables reflecting late outcome including adverse events and durability. In the context of durability, the event of interest was defined as the need for homograft replacement and homograft-related death. The mean follow-up time (SD) of study entrants (male/female ratio, 1.4) was 49.8 (36.3) months. Median age at the time of implantation was 11 years. Total 10-years mortality was 21 % (84/400), including 66.7 % early (30-days mortality: 56/84) and 33.3 % late (28/84). Overall late complication rate was 2 %. Median survival time was 120 months (95 % CI 83.3-156.6). The pulmonary valves appeared to be more durable (P value <0.001) and survival probabilities in small sized grafts were lower (P value 0.008). One-, five-, and ten-year graft survival was 82, 76 and 73 %, respectively. The evidences suggest that the homografts function satisfactory with low rate of late complications; nevertheless, more emphasis should be given to make long-term durability comparable.
- Subjects :
- Adolescent
Adult
Aged
Aged, 80 and over
Allografts
Child
Child, Preschool
Cryopreservation
Female
Follow-Up Studies
Humans
Infant
Iran epidemiology
Male
Middle Aged
Organ Preservation
Postoperative Complications epidemiology
Retrospective Studies
Survival Analysis
Tissue Banks
Tissue Donors
Transplantation, Homologous adverse effects
Transplantation, Homologous methods
Young Adult
Graft Survival
Heart Valves transplantation
Pulmonary Valve transplantation
Subjects
Details
- Language :
- English
- ISSN :
- 1573-6814
- Volume :
- 17
- Issue :
- 4
- Database :
- MEDLINE
- Journal :
- Cell and tissue banking
- Publication Type :
- Academic Journal
- Accession number :
- 27501816
- Full Text :
- https://doi.org/10.1007/s10561-016-9573-6