title: Dysfunction of the pulmonary homograft used in the reconstruction of the right ventricle exit tract.
abstract: BACKGROUND
  The pulmonary homograft has been used as an option in the correction of congenital cardiopathy with obstruction of the right ventricle exit tract. The long term results, however, are little satisfactory.
  
  
  OBJECTIVE
  Identify the risk factors associated to the dysfunction and the pulmonary homograft failure.
  
  
  METHODS
  Study with children submitted to the enlargement of the exit tract of the right ventricle with pulmonary homograft. The clinical, surgical, evolutional and morphological aspects of the prosthesis variables were analyzed as risk factors.
  
  
  RESULTS
  The final sample of 75 patients with median age at the surgery of 22 months, varying from 1-157 months, presented 13 patients (17.0%) who developed dysfunction of the homograft, characterized by stenosis or severe pulmonary insufficiency. The occurrence time between the homograft implant and the detection of the dysfunction was of 45 ± 20 months. When the size of the homograft was smaller than 21 mm and the Z score of the pulmonary valva is lower than zero, or higher than three, the risk factors were considered for the dysfunction occurrence.
  
  
  CONCLUSIONS
  The pulmonary homograft smaller than 21 mm and the inadequate pulmonary valva for the age and weight of the patient are determining factors for the prosthesis dysfunction.
authors.affiliation: Hospital Pequeno Príncipe, Pontificia Universidade Católica Paraná, Curitiba, PR, Brazil. andreawlenzi@yahoo.com.br
authors.forename: Andréa Weirich
authors.initials: AW
authors.lastname: Lenzi
authors.forename: Márcia
authors.initials: M
authors.lastname: Olandoski
authors.forename: Wanderley Saviolo
authors.initials: WS
authors.lastname: Ferreira
authors.forename: Fabio Said
authors.initials: FS
authors.lastname: Sallum
authors.forename: Nelson Itiro
authors.initials: NI
authors.lastname: Miyague
mesh_terms: D000293:Adolescent; D001021:Aortic Valve / Q000637:transplantation*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006350:Heart Valve Prosthesis; D006352:Heart Ventricles / Q000002:abnormalities / Q000601:surgery; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D016016:Proportional Hazards Models; D011475:Prosthesis Failure / Q000209:etiology*; D011664:Pulmonary Valve / Q000601:surgery*; D012307:Risk Factors; D014694:Ventricular Outflow Obstruction / Q000601:surgery*