Valved homograft conduit repair of the right heart in early infancy

Background. Valved homograft conduit repair in neonates and young infants c reates a physiologically normal biventricular circulation, and unlike shunt s, avoids surgery on the branch pulmonary. Methods. Retrospective chart review was used for 84 patients operated on be tween 1990 and 1995 (mean age 26 +/- 28 days, mean weight 3.3 +/- 0.8 kg) u ndergoing homograft conduit repair in the first 3 months of life. Cases wer e divided into simple and complex, eg, absent pulmonary valve syndrome or a ssociated interrupted arch. Mean homograft size was 9.0 +/- 2 mm. Results. Early mortality was 4.7% (simple) and 30% (complex). Mean hospital stay was 18 days. Mean follow-up was 34 months. Thirty-seven (47%) patient s underwent conduit replacement. Median time to reoperation was 3.1 years. Mean size of replacement homograft was 17 +/- 2 mm. There were no deaths at reoperation. Mean hospital stay at conduit change was 6.3 days. Probabilit y of survival at 5 years is 75%. Conclusions. Biventricular repair employing a conduit can be performed safe ly in noncomplex anomalies in the first 3 months of life. Time interval unt il repeat surgery is relatively short but equal or greater than that with m ost palliative procedures. (C) 1999 by The Society of Thoracic Surgeons.