Abstract 20027: Decellularized Aortic Allograft Vs. Pulmonary Autograft for Aortic Valve Replacement in Growing Sheep Model: Haemodynamic and Morphological Results After Implantation for 20 Months
Introduction: Pulmonary autograft (PA) represents the substitute of choice for aortic valve replacement especially in children and young adults. Similarly, decellularized aortic valves (DAV) showed excellent midterm function when implanted into the systemic circulation. The aim of this study was to compare DAVs to pulmonary autografts after Ross procedure in the growing sheep model.
METHODS AND RESULTS: Aortic valve root replacement was performed in lambs (35-45kg) using either DAVs (n=5) or PAs (n=5) as in Ross procedure. Haemodynamics were investigated by echocardiography and magnetic resonance imaging. The roots were explanted at 20 months and investigated by histology, immunohistochemistry, and transmission electron microscopy. The mean valve diameter increased from 14 to 23mm and from15 to 25mm in DAVs and PAs, respectively. Of all implanted grafts, only one PA exhibited moderate insufficiency at explantation. No significant differences were determined in mean transvalvular gradient between grafts of both groups at implantation and prior explantation. Cusps of all implants were soft, pliable without gross signs of degeneration. Repopulation with cells of DAVs occurred at the wall and cusp level without immune reaction. The endothelial lining was regularly restored.
Conclusion: Decellularized aortic allografts and pulmonary autografts provide adequate and comparable haemodynamics after aortic valve replacement in growing sheep. Furthermore, maintenance of valvular competence during enlargement of the valve ring indicates the capacity for physiological growth in both graft types.
Author Disclosures: I. Tudorache: None. K. Theodoridis: None. S. Samir: None. C. Bara: None. T. Meyer: None. K. Höffler: None. D. Hartung: None. A. Hilfiker: None. A. Haverich: None. S. Cebotari: None.
- © 2014 by American Heart Association, Inc.