APPLICATION OF FRESH AND CRYOPRESERVED HOMOGRAFTS HARVESTED FROM TRANSPLANT PATIENTS FOR CORRECTION OF COMPLEX CONGENITAL HEART-DISEASE

In recent years, the use of homograft tissue in cardiac surgery has in creased so that supply is limited. Since October 1990, aortic and/or p ulmonary valves were collected from 17 transplant recipients at the De partment of Cardiovascular Surgery of the University of Padova Medical School (11 male, 6 female, mean age 43.4 years, range 11 months to 61 years). The indications for transplant were dilated cardiomyopathy in 7, and end-stage ischemic heart disease in the remaining 10 patients. Twelve such valves have been subsequently reimplanted either as fresh or as cryopreserved valved homografts in the repair of different form s of congenital heart disease, by means of different tailoring techniq ues (7 male, 5 female; mean age 4.8 years [range 1 day to 18 years]; t ransposition of the great arteries = 5 cases; tetralogy of Fallot = 3 cases; hypoplastic left heart syndrome = 2 cases; double outlet right ventricle = 1 case; truncus arteriosus = 1 case). Overall, early morta lity was 25%. None of these deaths could be related to the use of homo grafts. There have been no instances of valve related complications am ong nine patients surviving surgery at a mean follow-up of 11 months. All patients having heart explanted should be regarded as potential so urces for aortic and pulmonary homografts.