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Eur J Cardiothorac Surg 2003;23:560-566
© 2003 Elsevier Science NL
a Department of Cardiovascular Surgery, Hôpital Européen Georges Pompidou, 20, rue Leblanc, 75015 Paris, France
b Department of Anesthesiology, Hôpital Européen Georges Pompidou, 20, rue Leblanc, 75015 Paris, France
c Department of Anatomopathology, Hôpital Européen Georges Pompidou, 20, rue Leblanc, 75015 Paris, France
d Department of Cardiac Surgery, Hôpital Pitié Salpetrière, 47/83 Boulevard de l'Hôpital, 75013 Paris, France
e Human Tissue Bank Hôpital Saint Louis, 1 avenue Claude Vellefaux, 75010 Paris, France
Received 24 September 2002; received in revised form 24 December 2002; accepted 29 December 2002.
* Corresponding author. Tel.: +33-1-56-09-36-26; fax: +33-1-56-09-22-19
e-mail: sylvain.chauvaud{at}egp.ap-hop-paris.fr
Objective: Mitral homograft (MH) can represent an interesting alternative for valve replacement in the young. However, concerns have been expressed about the durability of valve allografts in children. We report our experience with MH replacement in young patients. Methods: From 1993 to 1997, 13 young patients aged 3–25 years (mean 15±6 years) underwent total mitral valve (MV) replacement with a cryopreserved homograft (CH). All but one had previously undergone one or more cardiac operations. The indications were rheumatic disease (6), acute and subacute endocarditis (2), congenital heart disease (4), and systemic lupus endocarditis (1). Results: No in hospital deaths are reported. Discharge echocardiogram showed a well-functioning MH in all but one patient. One patient was lost to follow-up. Follow-up ranged from 0.7 to 6.6 years (4.1±2.2). On follow-up two patients were doing well. Two patients died without reoperation and both had MV stenosis. Seven patients (54%) required reoperation: mean delay 4.17 years (0.7–7). In all cases, thickening, shrinking and calcification of the allograft were present. None of these seven had contributive histopathologic changes. One patient presenting recurent MV insufficiency will require a reoperation. Conclusion: MV homograft is a safe and reproducible technique, but does not provide durable results and should not be used in young patients.
Key Words: Mitral valve homograft • Mitral valve reconstruction
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