Preserved Homograft Research Articles

The long term results of the Ross procedure: The importance of candidate selection

The Ross procedure has been considered in children as an optimal surgical procedure due to potential growth of the aortic annulus, lack of anticoagulation requirement, very low morbidity rate and excellent survival.Five-hundred-thirty-six (366 male, mean age 29.4 ± 11.1 years) underwent Ross procedure between 1990 and 2016 and had complete clinical and echocardiographic follow-up. Mean follow-up was 16.3 ± 4.9 years. Patients were divided in 2 groups according to age at surgery. Group 1 consisted of 320 (60%) patients less than 18 years old (223 male, mean age at surgery of 9.5 ± 5.6 years). Group 2 consisted of 216 (40%) patients older than 18 years of age (143 male, mean age at surgery of 26.3 ± 8.2 years).One-hundred-thirty (24%) patients had a redo procedure or surgery. Freedom from all re-operation and or percutaneous reintervention on either the aortic and pulmonary valves was 99% after 1 year, 94% after 5 years, 89% after 10 years, 83% after 15 years and 78% after 20 years. Freedom from redo surgery for AV 99% after 1 year, 94% after 5 years, 90% after 10 years, 81% after 15 years and 80% after 20 years. Freedom from redo surgery for PV was 100% after 1 year, 95% after 5 years, 89% after 10 years, 78% after 15 years and 76% after 20 years.The ideal candidate for Ross operation is a patient with congenital aetiology and an aortic root diameter ≤ 15 mm/m2. A pulmonary fresh preserved homograft seems to perform better on the long term.

Study of Rabbit Septal Cartilage Grafts Placed on the Nasal Dorsum

To compare the reabsorption characteristics of fresh septal cartilage autografts, preserved homografts, and preserved autografts in the nasal dorsum of rabbits. Rabbit nasal dorsum cartilage grafts were placed in 3 groups. The first group used fresh autologous cartilage; the second group, alcohol-preserved homologous cartilage; and the third group, alcohol-preserved autologous cartilage. Each rabbit received 2 grafts, one crushed and another noncrushed. After 16 weeks, the grafts were removed for analysis. No graft calcification occurred in any group. Chondrogenesis was observed in all groups. The fresh autograft group had the best results in the evaluation of the area of graft recovered and chondrocyte viability. The preserved autologous and homologous grafts did not differ in relation to any of the variables analyzed. Crushed grafts had inferior results in the area of graft recovered and chondrocyte viability compared with the noncrushed forms. No significant difference among the 3 groups was noted in the thickness of the fibrous capsule that developed around the graft. The fresh cartilage autograft was superior to the crushed and uncrushed preserved homografts and autografts; both types of preserved grafts had equivalent histological results. The uncrushed forms were superior to the crushed forms.

Hepatic artery pseudoaneurysm with hemobilia following angioplasty after liver transplantation

A 58‐yr‐old female with primary biliary cirrhosis underwent an uncomplicated orthotopic liver transplantation. Elevated liver function tests 2 months post‐transplantation were evaluated with Doppler ultrasound and a hepatic artery stricture was documented. The hepatic artery stenosis was treated with angioplasty. She developed hemobilia 1 d after the procedure, which was confirmed by angiography. Emergent exploratory laparotomy revealed a pseudoaneurysm at the hepatic artery anastomosis. The pseudoaneurysm was resected and the proper hepatic artery of the graft was anastomosed to the splenic artery of the host using preserved homograft. Her post‐operative course was uneventful and liver function tests returned to normal quickly after the surgery. This report will discuss the unusual nature of this complication, and review the problem of hemobilia and pseudoaneurysms in liver transplant recipients.

The tile graft: A method of building the roof of the nose using preserved homograft septal cartilage

It is not easy to obtain a smooth nasal bridgeline when treating a twisted nose or in secondary rhinoplasties. A piece of cartilage shaped like a Spanish roofing tile has been very useful to eliminate irregularities of the skeleton and to obtain a round and regular dorsum. The pieces can readily be made by cutting parallel incisions either in the removed septum of the patient or in a preserved septum of another patient. The formation of a bank of septums is described. This procedure is of great help in treating small deformities of the nose on an outpatient basis.

The fate of cartilage grafts for ossicular reconstruction in tympanoplasty.

Summary--Six autograft tragal cartilages and two preserved homograft nasal septal cartilages removed from revision tympanoplasty were examined with histologic and histochemical stains. The implanted cartilage remained in the middle ear from six months to eighteen months without significant inflammatory reaction or evidence of resorption. It appears that the implanted cartilages removed from tympanoplasty have been well tolerated in the middle ear space.

Use of Valve-Retaining Homograft and Heterograft Patch for Reconstruction of Right Ventricular Outflow Tract: Clinical Experience in Tetralogy of Fallot

Thirteen patients with severe tetralogy of Fallot underwent reconstruction for hypoplastic pulmonary artery and diffuse tubular outflow tract obstruction using a preserved homograft or heterograft patch with single or double cusps. The early and late results with our valve-retaining patch provide encouragement for the further application of this method to patients having extremely hypoplastic right ventricular outflow tracts. Pulmonic grafts appear to be preferable to aortic grafts, although further evaluation of these pulmonary homografts and heterografts is needed.

Biological (homo-, heterologous) aortic valve replacement.

Fresh heterologous aortic valve has a stronger antigenicity than fresh homologous valve, but preserved heterologous valve shows antigenicity only in about the same degree as fresh homologous valve. The tensile strength of such a preserved valve differs not much from that of fresh valve. On the basis of these findings, the replacement surgery was performed on 10 patients with aortic valvular disease using preserved homograft or preserved heterograft. For operative procedures continuous single layer suture coupled with mattress suture of the lower end of commissure were employed, but no leakage was observed due to this method. Excepting the two cases which required the change to prosthesis immediately after the operation, two cases of the 8 showed postoperative systolic gradient across the aortic valve of 15-20 mmHg. Three cases died due to the cerebral damage, postoperative respiratory disturbances and acute bacterial endocarditis resulting from the heart-lung bypass, and one case required reoperation due to aortic incompetence by the rupture of cusp. Those given homograft amount to 4 cases, those receiving heterograft 6 cases; and the formalin preserved valves were given to 5 cases and the freeze-dried valves to 5 cases, but there could be observed no prominent difference in these cases. While the number of cases handled is small and the results are also not quite so satisfactory, it has been demonstrated that biologic valves including preserved heterologous valves are excellent for the substitute valve. Therefore, the results are present as a preliminary report of the study in this line.

The fate of preserved homograft pericardium and autogenous pericardium within the heart.

Animal experiments were performed to assess the usefulness of preserved homograft pericardium for intracardiac surgery, with particular reference to the problem of homograft mitral valve papillary muscle fixation. The fate of fresh autogenous pericardium was also studied. Both homograft and autogenous pericardium were destroyed and replaced by fibrous tissue. This reaction was faster when the pericardium was in direct contact with the blood stream and slower when it was buried within the myocardium. As homograft pericardium provided a more intense fibrous reaction than autogenous pericardium, it was considered to be very suitable for papillary muscle fixation and less suitable for other intracardiac procedures. The technique used for attaching the papillary muscle of a homograft mitral valve is briefly described.

Aortic Homograft Preservation With Dimethyl Sulfoxide

THIS REPORT defines a technique of arterial homograft preservation. It does not attempt to evaluate different arterial grafting materials nor does it evaluate the long-term problems of implanted arterial homografts. The first homograft implant was carried out in the dog by Höpfner.¹In 1910 Carrel²reported results of his investigations in the use of preserved homografts. His preservation techniques included the use of physiological saline solution, Locke's solution, serum, and defibrinated dog's blood at refrigerator temperatures and at temperatures of −3 C. Carrel also attempted desiccating the arteries over calcium chloride and later reconstituting them in Locke's solution. Levin³attempted preservation of aortas in formaldehyde solution (formalin). The report of Gross⁴and his associates in 1949 of homografts stored at 4 C in 10% homologous serum electrolyte solution revived interest in the arterial homograft. Hufnagel,⁵Deterling,⁶and Meeker and Gross⁷studied techniques for

Postmortem homografts as ???biological dressings??? for extensive burns and denuded areas. Immediate and preserved homografts as life-saving procedures

Postmortem homografts as ???biological dressings??? for extensive burns and denuded areas. Immediate and preserved homografts as life-saving procedures