ArticleJTCVS open2025
Longevity of homograft conduits for infant right ventricular outflow tract reconstruction in the modern era.
Article in JTCVS open, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Authors and funding
5 authors.
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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: A total of 74 patients met the inclusion criteria, who had a median age of 1.8 months (interquartile range [IQR], 0.3-5.5 months) and median weight of 4.2 kg (IQR, 3.2-5.8 kg) at homograft implantation. The cumulative incidence was 44.1% for surgical reintervention within 2 years and 12.3% for death before reoperation. Younger age, lower weight, smaller homograft size, and lower homograft 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.
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