Document Detail


Performance and morphology of decellularized pulmonary valves implanted in juvenile sheep.
MedLine Citation:
PMID:  21718838     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
BACKGROUND: Because of cryopreserved heart valve-mediated immune responses, decellularized allograft valves are an attractive option in children and young adults. The objective of this study was to investigate the performance and morphologic features of decellularized pulmonary valves implanted in the right ventricular outflow tract of juvenile sheep.
METHODS: Right ventricular outflow tract reconstructions in juvenile sheep (160 ± 9 days) using cryopreserved pulmonary allografts (n = 6), porcine aortic root bioprostheses (n = 4), or detergent/enzyme-decellularized pulmonary allografts (n = 8) were performed. Valve performance (echocardiography) and morphologic features (gross, radiographic, and histologic examination) were evaluated 20 weeks after implantation.
RESULTS: Decellularization reduced DNA in valve cusps by 99.3%. Bioprosthetic valves had the largest peak and mean gradients versus decellularized valves (p = 0.03; p < 0.001) and cryopreserved valves (p = 0.01; p = 0.001), which were similar (p = 0.45; p = 0.40). Regurgitation was minimal and similar for all groups (p = 0.16). No cusp calcification was observed in any valve type. Arterial wall calcification was present in cryopreserved and bioprosthetic grafts but not in decellularized valves. No autologous recellularization or inflammation occurred in bioprostheses, whereas cellularity progressively decreased in cryopreserved grafts. Autologous recellularization was present in decellularized arterial walls and variably extending into the cusps.
CONCLUSIONS: Cryopreserved and decellularized graft hemodynamic performance was comparable. Autologous recellularization of the decellularized pulmonary arterial wall was consistently observed, with variable cusp recellularization. As demonstrated in this study, decellularized allograft valves have the potential for autologous recellularization.
Authors:
Rachael W Quinn; Stephen L Hilbert; Arthur A Bert; Bill W Drake; Julie A Bustamante; Jason E Fenton; Sara J Moriarty; Stacy L Neighbors; Gary K Lofland; Richard A Hopkins
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The Annals of thoracic surgery     Volume:  92     ISSN:  1552-6259     ISO Abbreviation:  Ann. Thorac. Surg.     Publication Date:  2011 Jul 
Date Detail:
Created Date:  2011-07-01     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  15030100R     Medline TA:  Ann Thorac Surg     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  131-7     Citation Subset:  AIM; IM    
Copyright Information:
Copyright © 2011 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.
Affiliation:
Cardiac Surgery Research Laboratories of the Ward Center for Congenital Heart Disease of The Children's Mercy Hospital, Kansas City, Missouri.
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