THE FATE OF HOMOGRAFT CONDUITS IN CHILDREN WITH CONGENITAL HEART-DISEASE - AN ANGIOGRAPHIC STUDY

The use of homograft conduits in the repair of congenital heart diseas e is widely accepted. We reviewed the catheterization and angiographic data from 20 patients with homograft conduits. All conduits were to t he pulmonary arteries. The age at operation was 4.7 +/- 5.6 years (mea n +/- standard deviation) and at follow-up catheterization, 7.8 +/- 6. 7 years. At implantation, conduit cross-sectional area and Z value wer e 219 +/- 96 mm(2) and 3.5 +/- 1.8, respectively. At subsequent cathet erization, the conduit diameters were measured in two projections at t he shaft, annulus, valve opening, and insertion into the pulmonary art ery. The transconduit gradient was 47 +/- 26 mm Hg. The cross-sectiona l areas were 149 +/- 56 mm(2) at the shaft, 151 +/- 92 mm(2) at the an nulus, 108 +/- 116 mm(2) at the valve opening, and 127 +/- 84 mm(2) at the pulmonary artery insertion. The Z values were -0.9 +/- 2.5, -0.9 +/- 2.8, -3.8 +/- 4.0, and -2.0 +/- 3.4, respectively. The cross-secti onal areas and the Z values at the levels of measurement were signific antly smaller than the corresponding values at implantation. The chang e in cross-sectional areas and Z values exceeded what would be expecte d from growth alone. These data indicate that there is a decrease, wit h time, in the functional lumen of homograft conduits, and this may ha ve implications for follow-up strategy after implantation.