Abstract

Objective: This study reports our experience for RVOT reconstruction with Allografts and attempts to identify patients own as well as Allograft related variables which may affect the outcome.

Methods: Between 1971 and 1997, 279 patients, mostly with complex congenital heart disease underwent procedures including RVOT reconstruction with Allograft. In 185 patients Allografts were used as valved conduits (group A) and in 94 as mono or bicuspid patch (group B). Data for 1662 patient/years of follow up were collected. Short and long term outcome were studied by multivariate analysis.

Results: The hospital mortality for group A was 14 (7.5%) and for group B 12 (12.7%). None appeared to be related to the Allograft or valve dysfunction. The late mortalities were respectively 3 (1.7%) and 1 (1.2%) for each group. 12 (6.6%) patients in group A and 5 (6%) in group B underwent Allograft replacement 5 to 193 months later (mean 61 months) in group A and 29 to 127 months (mean 69 months) in group B. One patient was reoperated twice. The mortality for Allograft replacement was nil. Not all patients with structural deterioration of their Allograft necessitated replacement.

Conclusions: The use of Allografts in RVOT reconstruction has overall excellent short and long term result. Better technics in harvesting and preservation have further improved the durability and hence the outcome.