title: Iranian homograft heart valves: assessment of durability and late outcome.
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.
authors: Iranian Tissue Bank and Research Center, Tehran University of Medical Sciences, Imam Khomeini Hospital Complex, Keshavarz Blvd., Tehran, 1419731351, Iran.
authors: Alireza
authors: A
authors: Heidary Rouchi
authors: Department of Cardiac Surgery, Children Medical Center, Tehran University of Medical Sciences, Tehran, Iran.
authors: Hassan
authors: H
authors: Radmehr
authors: Iranian Tissue Bank and Research Center, Tehran University of Medical Sciences, Imam Khomeini Hospital Complex, Keshavarz Blvd., Tehran, 1419731351, Iran.
authors: Seyed Amirhosein
authors: SA
authors: Tavakoli
authors: Dental Materials Department, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran.
authors: Tahereh Sadat
authors: TS
authors: Jafarzadeh Kashi
authors: Iranian Tissue Bank and Research Center, Tehran University of Medical Sciences, Imam Khomeini Hospital Complex, Keshavarz Blvd., Tehran, 1419731351, Iran. mmahdavi@tums.ac.ir.
authors: Mitra
authors: M
authors: Mahdavi-Mazdeh
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D064591:Allografts; D002648:Child; D002675:Child, Preschool; D015925:Cryopreservation; D005260:Female; D005500:Follow-Up Studies; D006085:Graft Survival; D006351:Heart Valves / Q000637:transplantation*; D006801:Humans; D007223:Infant; D007492:Iran / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009926:Organ Preservation; D011183:Postoperative Complications / Q000453:epidemiology; D011664:Pulmonary Valve / Q000637:transplantation*; D012189:Retrospective Studies; D016019:Survival Analysis; D014015:Tissue Banks; D014019:Tissue Donors; D014184:Transplantation, Homologous / Q000009:adverse effects / Q000379:methods; D055815:Young Adult
keywords: Complication; Durability; Homograft; Survival; Valve replacement