Document Detail


Fifty-two months' mean follow up of decellularized SynerGraft-treated pulmonary valve allografts.
MedLine Citation:
PMID:  18365576     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND AND AIM OF THE STUDY: It has been reported previously that the use of a decellularized pulmonary allograft (SynerGraft; CryoLife Inc.) for right ventricular outflow tract reconstruction in adults is associated with reduced immunization. The implantation appeared to be safe, but was not associated with any detectable clinical or echocardiographic advantage. The study aim was to follow further the outcome of SynerGraft patients. METHODS: Twenty-three adult patients (19 males, four females) each received a SynerGraft-allograft during a Ross procedure. A further 49 patients (37 males, 12 females) who underwent a Ross procedure using a conventional pulmonary allograft during the same period served as controls. Follow up examinations using transthoracic echocardiography in standard views was performed on a regular basis. The latest follow up was performed after a mean of 52 months. RESULTS: Directly after implantation, there were no echocardiographic differences between the two groups, but with time the pressure gradients increased significantly (p <0.001) in both groups. At the latest follow up, pressure gradients were slightly higher across the SynerGraft-allograft valves than across conventional allografts (Pmax 18.2 +/- 9.0 versus 14.0 +/- 6.9 mmHg, respectively; p = 0.049). On regression analysis (considering pre- and intraoperative variables), 'SynerGraft-allograft' was the only variable predicting the increase in pressure gradient from its postoperative value to that at follow up. However, no clinical differences were observed between the groups. CONCLUSION: The present results relate to the longest follow up on decellularized pulmonary SynerGraft-allografts conducted to date. No reoperations were required after a mean follow up of 52 months, and the echocardiographic results were stable after the first postoperative year. Based on these data, the use of pulmonary SynerGraft-allograft valves in adults appears not to provide any advantage over conventional allografts, although further follow up is warranted before any final judgment is made regarding this new technology.
Authors:
J F Matthias Bechtel; Ulrich Stierle; Hans-Hinrich Sievers
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  The Journal of heart valve disease     Volume:  17     ISSN:  0966-8519     ISO Abbreviation:  J. Heart Valve Dis.     Publication Date:  2008 Jan 
Date Detail:
Created Date:  2008-03-27     Completed Date:  2008-05-20     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9312096     Medline TA:  J Heart Valve Dis     Country:  England    
Other Details:
Languages:  eng     Pagination:  98-104; discussion 104     Citation Subset:  IM    
Affiliation:
Department for Cardiac and Thoracic Vascular Surgery, University of Luebeck, Germany.
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MeSH Terms
Descriptor/Qualifier:
Adult
Blood Flow Velocity
Cryopreservation / methods*
Echocardiography, Doppler, Pulsed
Female
Follow-Up Studies
Heart Valve Prosthesis Implantation / instrumentation*
Humans
Male
Middle Aged
Prosthesis Design
Pulmonary Valve / transplantation*
Retrospective Studies
Suture Techniques
Time Factors
Transplantation, Homologous
Treatment Outcome
Ventricular Outflow Obstruction / physiopathology,  surgery*,  ultrasonography
Ventricular Pressure / physiology

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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