Impact of valve fenestrations and structural changes in homografts on the long-term outcome in the recipient

This study analyzes the long-term outcome of patients receiving a homograft with small fenestrations of the cusps or other structural changes, to evaluate if minor impairment of the homograft affects the durability. Homograft characteristics and patient outcome were described. Follow-up was maximum 24  years. Structural changes of the homografts were analyzed in relation to patient outcome, using univariable and multivariable Cox proportional hazard regression. Between 1995 and 2018, 468 patients received 535 homografts in the RVOT in Lund. Median recipient age was 13 years. There were 137 (26. 9%) reinterventions. Freedom from reintervention was 75.8% (95% CI 71.3–79.7%) at 10 years and 57.4% (95% CI 50.0–64.0%) at 20 years. Small fenestrations of the cusps, fibrosis of the cusps and minor atheromatosis of the vessel did not show any statistically significant impact on long-term out come, hazard ratio = 0.46 (95% CI 0.11–1.87,p = 0.276) and hazard ratio = 0.80 (95% CI 0.25–2.56,p = 0.704). Minor structural changes of the homografts seem to be acceptable without affecting the long-term durability.

Source: Cell and Tissue Banking - February 12, 2021 Category: Stem Cells Source Type: research