The early primary repair of TAC with diminished bicuspid homograft application - late and midterm results

Introduce: TAC is a rare kind of congenital heart defect and makes up 2-4% of all congenital heart diseases. We recognize different types of TAC depending on pulmonary artery origin from aorta. Aim: The goat of this paper is to assess reduced-to-bicuspid pulmonary homograft in mid-term and late follow-up. Material and Methods: From August 1991 until December 2006, 23 pts underwent TAC repair in the Cardiosurgery Department in the Polish Mothers' Memorial Hospital. Reduction of implanted homograft to bicuspid (during operation) was performed in 13 of them. This group was thoroughly assessed in mid-term and late follow-up based essentially on ECHO examination. Truncal valve regurgitation and homograft valve stenosis or regurgitation were analyzed. Results: We revealed no statistical differences in mortality and morbidity in patients with or without homograft reduction. None required redo procedure for aortic valve dysfunction. There were 2 pts in our series reoperated on due to homograft dysfunction respectively 2 and 5 yrs after primary repair. Conclusions: We conclude that long-term follow-up revealed quite good function of the implanted homograft. Increasing flow gradient across the homograft valve may be a natural sequel of somatic child growth or possible degenerative processes.