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Impact of valve fen...
Impact of valve fenestrations and structural changes in homografts on the long-term outcome in the recipient
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- Axelsson, Ida (author)
- Lund University,Lunds universitet,Thoraxkirurgi,Sektion II,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Thoracic Surgery,Section II,Department of Clinical Sciences, Lund,Faculty of Medicine,Skåne University Hospital
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- Malm, Torsten (author)
- Lund University,Lunds universitet,Thoraxkirurgi,Sektion II,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Thoracic Surgery,Section II,Department of Clinical Sciences, Lund,Faculty of Medicine,Skåne University Hospital
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- Nilsson, Johan (author)
- Lund University,Lunds universitet,Thoraxkirurgi,Sektion II,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Hjärt- och lungtransplantation,Forskargrupper vid Lunds universitet,Artificiell intelligens och thoraxkirurgisk vetenskap (AICTS),Artificiell intelligens och bioinformatik inom thoraxkirurgisk vetenskap,Thoracic Surgery,Section II,Department of Clinical Sciences, Lund,Faculty of Medicine,Heart and Lung transplantation,Lund University Research Groups,Artificial Intelligence in CardioThoracic Sciences (AICTS),Artificial Intelligence and Bioinformatics in Cardiothoracic Sciences (AIBCTS),Skåne University Hospital
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(creator_code:org_t)
- 2021-02-12
- 2021
- English.
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In: Cell and Tissue Banking. - : Springer Science and Business Media LLC. - 1389-9333 .- 1573-6814. ; 22:3, s. 399-408
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Abstract
Subject headings
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- Homografts have long been used for right ventricular outflow tract (RVOT) reconstruction. Tissue banks struggle to meet the clinical demand of tissue, with insufficient donor availability and strict recommendations on tissue quality with high proportions of discards. This study analyzes the long-term outcome of patients receiving a homograft with small fenestrations of the cusps or other structural changes, to evaluate if minor impairment of the homograft affects the durability. Homograft characteristics and patient outcome were described. Follow-up was maximum 24 years. Structural changes of the homografts were analyzed in relation to patient outcome, using univariable and multivariable Cox proportional hazard regression. Between 1995 and 2018, 468 patients received 535 homografts in the RVOT in Lund. Median recipient age was 13 years. There were 137 (26.9%) reinterventions. Freedom from reintervention was 75.8% (95% CI 71.3–79.7%) at 10 years and 57.4% (95% CI 50.0–64.0%) at 20 years. Small fenestrations of the cusps, fibrosis of the cusps and minor atheromatosis of the vessel did not show any statistically significant impact on long-term outcome, hazard ratio = 0.46 (95% CI 0.11–1.87, p = 0.276) and hazard ratio = 0.80 (95% CI 0.25–2.56, p = 0.704). Minor structural changes of the homografts seem to be acceptable without affecting the long-term durability.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Kardiologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Cardiac and Cardiovascular Systems (hsv//eng)
Keyword
- Homograft
- Long-term outcome
- Right ventricular outflow tract
- Tissue bank
- Valve fenestrations
Publication and Content Type
- art (subject category)
- ref (subject category)
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