The fate of homograft conduits in children with congenital heart disease: an angiographic study

The use of homograft conduits in the repair of congenital heart disease is widelym accept. We reviewed the catherization and angiographic data from 20 patients with ho,ograft conduits. All conduits were to the pilmonary arteries. The age at operation was 4.7 ± 5.6 years (mean ± standard deviation) and at follow-up catheterization, 7.8± 6.7 years. At implantation, conduit cross-sectional area and Z value were 219 ± 96 mm2 and 3.5 ± 1.8, respectively. At subsequent catheterization, the conduit diameters were measured in two projections at the shaft, 151 ± 92 mm2 at the annulus, 108 ± 116 mm2 at the valve opening, and 127 ± 84 mm2 at the pulmonary artery insertion. The Z values were -0.9 ± 2.5, -0.9 ± 2.8, -3.8 ± 4.0, and -2.0 ± 3.4, respectively. The crosssectional areas and the Z values at the levels of measurement were significantly smaller than the corresponding values at implantation. The change in cross-sectional areas and Z values exceeded what would be expected from growth alone. These data indicate that there is a decrease, with time, in the functional lumen of homograft conduits, and this may have implications for follow-up strategy after implantation.