Midterm Follow-up after Cryopreserved Homograft Replacement in the Aortic Position

Abstract

Background: The long-term results of homografts used in systemic circulation are controversial. We assessed the long-term results of using a cryopreserved homograft for an aortic root or aorta and its branch replacement.

Materials and methods: From June 1995 to January 2010, 23 patients (male:female=15:8, 45.4±15.6 years) underwent a homograft replacement in the aortic position. The surgical techniques used were aortic root replacement in 15 patients and aortic graft interposition in 8 patients. Indications for the use of a homograft were systemic vasculitis (n=15) and complicated infection (n=8). The duration of clinical follow-up was 65±58 months.

Results: Early mortality occurred in 2 patients (8.7%). Perioperative complications included atrial arrhythmia (n=3), acute renal failure (n=3), and low cardiac output syndrome (n=2). Late mortality occurred in 6 patients (26.1%). The overall survival rates at 5 and 10 years were 66.3% and 59.6%, respectively. Six patients (28.6%) suffered from homograft-related complications.

Conclusion: Early results of homograft replacement in aortic position were favorable. However, close long-term follow-up is required due to the high rate of homograft-related events.

Keywords: Aorta; Aortic root; Endocarditis; Homograft.

Fig. 1

Log-rank tests demonstrated that overall survival rates were not related to the indication of the use of homograft (A) or the type of operation (B). ARR=aortic root replacement.

Fig. 2

The difference in homograft-related event-free survival rates according to the indications of homograft replacement.