Abstract 19959: Aortic Valve Replacement with Decellularized Aortic Allografts: First Clinical Results
Background: Valve prosthesis selection for aortic valve replacement (AVR) for young recipients is still challenging. In pulmonary position, the use of decellularized homografts (DH) shows superior results when compared to other grafts. Here, we report about our clinical results of AVR using decellularized aortic homografts (DAH) in children and adults.
Methods and Results: From February 2008 to June 2014, 43 patients (28 male) with a mean age of 22 years (range 0.2 to 65.3) underwent AVR using DAH with coronary re-implantation. In two patients concomitant other procedures were performed. Echocardiography and magnetic resonance imaging were used for postoperative evaluation. 23 patients (51.2%) had 34 previous operations in total. Mean aortic cross-clamp time in the isolated cases was 126.1 ± 37.1 min. AV z-values at implantation were 1.3 ± 0.9. There was one early non conduit related death (2.3%).
No patient required conduit explantation so far. The mean DAH diameter at implantation was 22 mm (range 10 to 27). Total follow up is 74.0 ± 1.6 years, mean 1.7, max. 6.4. The following numbers are means and standard deviations of the latest examination: diameter change was 0±4mm; effective orifice area was 2.8 ± 0.3cm2; peak gradient was 14.5 ± 12.3 mmHg; aortic regurgitation grade (0.5=trace, 1=mild) was 0.6 ± 0.6; LV EF was 63.9 ± 9% and LV EDVi 74 ± 18 ml/m2 BSA; AV z-value was 0.5 ± 1.7. LV function was normal in 40 and mildly impaired in 3 patients. No dilatation of DAH was observed during the follow up.
Conclusion: Decellularized aortic homografts withstand systemic circulation and provide auspicious hemodynamic results up to 6 years. In our opinion, DAH should be considered as an alternative to conventional grafts for AVR in young patients.
Author Disclosures: I. Tudorache: None. A. Horke: None. S. Sarikouch: None. A. Ciubotaru: None. T. Breymann: None. D. Boethig: None. P. Beerbaum: None. H. Bertram: None. M. Westhoff-Bleck: None. L. Meschenmoser: None. S. Cebotari: None. A. Haverich: None.
- © 2014 by American Heart Association, Inc.