Work

Longevity of homograft conduits for infant right ventricular outflow tract reconstruction in the modern era

Year: 2025

Type: article

Abstract: Background: Homograft conduits are widely used for right ventricular outflow tract (RVOT) reconstruction. The literature reports a 50% 2-year freedom from reoperation for infants age <1 year. Recently, decellularized homografts and transcatheter interventions have been purported to prolong conduit longevity. This study evaluated homograft longevity in the modern era. Methods: All infants (age <1 year) receiving a homograft RVOT conduit at a single institution between 2006 and 2024 were reviewed. The cumulative incidence function was used to estimate the cumulative probability of reoperation within 2 years, accounting for the competing risk of death. A Fine-Gray regression model with subdistribution hazard ratios (sHRs) identified predictors for reoperation within 2 years. Data on transcatheter interventions also were collected to aid the analysis. Results: -score were associated with increased early reoperation. Nineteen patients (25.7%) had a transcatheter intervention, including 6 (31.6%) before a surgical reoperation, 6 (31.6%) after a surgical reoperation, and 7 (36.8%) without a surgical reintervention. Conclusions: Compared with the literature, time to operative reintervention after homograft RVOT reconstruction in infants age <1 year has not changed significantly in the modern era, despite the expanded use of decellularized homografts and catheter-based interventions.

Source: JTCVS Open

DOI: 10.1016/j.xjon.2025.09.015

Authors: Chen Chia Wang, Nanda Nayak, Jennifer D. Garcia, George T. Nicholson, David Bichell

Institutions: Vanderbilt University, Vanderbilt University Medical Center

Language: English

Topic: Congenital Heart Disease Studies

Subfield: Epidemiology

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $2,431