RF12 CLINICAL OUTCOME AND HEALTH RELATED QUALITY OF LIFE AFTER CRYOPRESERVED HOMOGRAFT IMPLANTATION FOR RIGHT VENTRICULAR OUTFLOW RECONSTRUCTION

Abstract

Background and Aim: To evaluate long term clinical outcomes and a cross-sectional quality of life study, in congenital patients after right ventricular outflow tract (RVOT) reconstruction with cryopreserved pulmonary homograft (HG). Methods: 110 patients (pts) undergone RVOT reconstruction with cryopreserved pulmonary HG from January 1995 to September 2014 were included in this retrospective review. Homograft's failure was diagnosed in presence of pulmonary valve peak gradient ≥50mmHg and/or moderate to severe degree of valve regurgitation. Mean diameter of HG implanted was 22 mm and donors’ mean age 39.1 ± 16.0years. Follow-up data included echocardiogram, cardiac MRI and clinical evaluation. The Short-Form-36 was presented to patients to assess perceived quality of life. Results: Mean age at surgery was 24.5 ± 15 years. Mean follow-up was10.1 ± 5 years. There was no perioperative mortality. At follow-up, 2 pts (1.8%) died due to non cardiac comorbidities. Homograft failure was observed in 6 pts (5,4%): 5 required percutaneous valve implantation, with a mean interval from the main procedure of 5.3 ± 2.1years and 1 pt required HG replacement after 7years for pseudoaneurysm formation. Freedom from reoperation was 92% and 84% at 5 and 15 years respectively. At follow-up reduction of RV dilatation was observed in 71%pts with ED-volume 98.5 ± 26.1 ml/mq, ES-volume 50.1 ± 16.1 ml/mq, RVEF50.7 ± 6.9% and LVEF59.2 ± 6.9%. HG initial diameter was not a significant prognostic factor for HG dysfunction. Conclusions: Cryopreserved pulmonary homograft represent a valid option in case of right ventricular outflow tract reconstruction, as it is associated with low failure rate and no mortality in the long term.