LONG-TERM RESULTS OF THE GAMMA-IRRADIATION-PRESERVED HOMOGRAFT MONOCUSP FOR TRANSANNULAR RECONSTRUCTION OF THE RIGHT-VENTRICULAR OUTFLOW TRACT IN TETRALOGY OF FALLOT

The long-term results of a consecutive series of transannular gamma-ir radiated homograft monocusp patches in tetralogy of Fallot were studie d. Seven survivors out of 8 patients are doing clinically well after a mean of 22.4 years of follow-up, 5 of them being in New York Heart As sociation class I and 2 in class II. In one patient the completely cal cified gamma-irradiated homograft monocusp patch was replaced 15 years after intracardiac repair. Echocardiographic investigation at the end of follow-up of the remaining 6 patients with a gamma-irradiated homo graft monocusp patch in situ showed mild pulmonary regurgitation in 1, moderate regurgitation in 3, and severe regurgitation in 2. Residual pulmonary stenosis was present in 4 patients (gradients ranging from 1 0 to 40 mmHg). Right-ventricular dilatation was present in all patient s. In the long-term the gamma-irradiated transannular homograft monocu sp patch behaves like a simple transannular patch.