Application of fresh and cryopreserved homografts harvested from transplant patients for correction of complex congenital heart disease

In recent years, the use of homograft tissue in cardiac surgery has increased so that supply is limited. Since October 1990, aortic and/or pulmonary valves were collected from 17 transplant recipients at the Department of Cardiovascular Surgery of the University of Padova Medical School (11 male, 6 female, mean age 43.4 years, range 11 months to 61 years). The indications for transplant were dilated cardiomyopathy in 7, and end-stage ischemic heart disease in the remaining 10 patients. Twelve such valves have been subsequently reimplanted either as fresh or as cryopreserved valved homografts in the repair of different forms of congenital heart disease, by means of different tailoring techniques (7 male, 5 female; mean age 4.8 years [range 1 day to 18 years]; transposition of the great arteries = 5 cases; tetralogy of Fallot = 3 cases; hypoplastic left heart syndrome = 2 cases; double outlet right ventricle = 1 case; truncus arteriosus = 1 case). Overall, early mortality was 25%. None of these deaths could be related to the use of homografts. There have been no instances of valve related complications among nine patients surviving surgery at a mean follow-up of 11 months. All patients having heart explanted should be regarded as potential sources for aortic and pulmonary homografts.