title: Mid- to long-term outcomes of cardiovascular tissue replacements utilizing homografts harvested and stored at Japanese institutional tissue banks.
abstract: OBJECTIVE
  We reviewed our clinical experiences with cardiovascular homografts harvested and preserved at our institutional tissue banks.
  
  
  METHODS
  Since our bank was first established in Japan in 1990, 74 patients have undergone various surgical procedures using homografts. We classified them into five groups according to the procedure: Group I, subcoronary implantation of a homograft aortic valve; Group II, homograft aortic root replacement for active native or prosthetic endocarditis; Group III, homograft aortic replacement for mycotic aortic aneurysms or infected grafts; Group IV, pulmonary homografts in the Ross operation; and Group V, pulmonary homograft conduits for complex congenital heart diseases.
  
  
  RESULTS
  The 9- to 10-year survival rates were good and acceptable, respectively, for the patients in all five groups. The infection recurrence rate was low (8%). Cardiac event-free rates, including deaths, were 0.57 in Group I, 0.58 Group in II, 0.75 in Group III, 0.81 in Group IV, and 0.69 in Group V operations. The rates of structural homograft deterioration suggest that homografts deteriorate more rapidly after subcoronary implantation than aortic root replacements (P = 0.058).
  
  
  CONCLUSIONS
  Subcoronary implantation should probably be abandoned for routine aortic valve replacement, but the continued use of homografts will provide valuable alternatives for patients with active infectious cardiovascular diseases. For the Ross operation, pulmonary valve homografts showed good durability.
authors: Department of Cardiovascular Surgery, National Cerebral and Cardiovascular Center, 5-7-1 Fujishirodai, Suita, Osaka, 565-8565, Japan.
authors: Soichiro
authors: S
authors: Kitamura
authors: Toshikatsu
authors: T
authors: Yagihara
authors: Junjiro
authors: J
authors: Kobayashi
authors: Hiroyuki
authors: H
authors: Nakajima
authors: Koichi
authors: K
authors: Toda
authors: Tomoyuki
authors: T
authors: Fujita
authors: Hajime
authors: H
authors: Ichikawa
authors: Hitoshi
authors: H
authors: Ogino
authors: Takeshi
authors: T
authors: Nakatani
authors: Shigeki
authors: S
authors: Taniguchi
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001014:Aortic Aneurysm / Q000601:surgery*; D001021:Aortic Valve / Q000637:transplantation*; D019917:Blood Vessel Prosthesis Implantation / Q000379:methods*; D002648:Child; D004696:Endocarditis / Q000601:surgery*; D005260:Female; D006330:Heart Defects, Congenital / Q000601:surgery*; D019918:Heart Valve Prosthesis Implantation / Q000379:methods*; D006801:Humans; D007564:Japan; D008297:Male; D008875:Middle Aged; D011664:Pulmonary Valve / Q000637:transplantation*; D012008:Recurrence; D015996:Survival Rate; D014015:Tissue Banks; D014021:Tissue Preservation / Q000379:methods; D009927:Tissue and Organ Procurement / Q000379:methods; D014184:Transplantation, Homologous