| The early and midterm function of decellularized aortic valve allografts. | |
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MedLine Citation:
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PMID: 21095325 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: This study evaluates the early and midterm results of decellularized aortic valve allografts (DAVA) as an aortic valve replacement. METHODS: Between October 2005 and February 2010, 41 patients, 28 of whom were male, with a median age of 34 years (range, 0.1 to 71), had aortic valve replacement with DAVA. Decellularization was obtained with a 0.1% sodium dodecyl sulfate solution. Postoperative evaluation was performed with serial echocardiograms, magnetic resonance imaging, and multislice computed tomography studies to evaluate valve hemodynamics, allograft conduit dimensions, and calcification scores. RESULTS: There were 3 early deaths and 1 late death, with a mean follow-up of 19 months (range, 1 to 53). There was 1 reoperation due to a failed mitral valve repair. By echocardiography in all patients, the median immediate postoperative peak gradient was 7 mm Hg (range, 1 to 26 mm Hg), and at last follow-up it was 4 mm Hg (range, 1 to 16 mm Hg); valvular regurgitation was graded as none or trivial in all but 1 patient, who had a regurgitation graded as mild to moderate. By magnetic resonance imaging (n = 4), mean root dimensions were stable at the annulus (24 mm), sinus of Valsalva (33 mm), and sinotubular junction (28 mm). By computed tomography (n = 22), there was only discrete conduit calcification (median calcium score 63 Hounsfield units [HU]; range, 0 to 894 HU) to 3 years of follow-up. Conduit biopsy in the patient who underwent reoperation demonstrated well-preserved wall structure, absence of calcification, and limited in vivo host repopulation. CONCLUSIONS: The early and midterm results with DAVA demonstrated stable structural integrity, low rate of calcification, and adequate hemodynamics. Although longer periods of observation are necessary, DAVA appears to be a promising alternative for aortic valve replacement in selected patients. |
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Authors:
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Francisco D A da Costa; Ana Claudia B A Costa; Roberta Prestes; Ana Carolina Domanski; Eduardo Mendel Balbi; Andreia D A Ferreira; Sergio Veiga Lopes |
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Publication Detail:
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Type: Comparative Study; Journal Article |
Journal Detail:
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Title: The Annals of thoracic surgery Volume: 90 ISSN: 1552-6259 ISO Abbreviation: Ann. Thorac. Surg. Publication Date: 2010 Dec |
Date Detail:
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Created Date: 2010-11-24 Completed Date: 2011-01-18 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 15030100R Medline TA: Ann Thorac Surg Country: Netherlands |
Other Details:
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Languages: eng Pagination: 1854-60 Citation Subset: AIM; IM |
Copyright Information:
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Copyright © 2010 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved. |
Affiliation:
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Department of Cardiac Surgery, Santa Casa de Curitiba, Pontificia Universidade Catolica do Parana, Curitiba, Paraná, Brazil. fcosta13@mac.com |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adolescent Adult Aged Aortic Valve / physiopathology, transplantation* Aortic Valve Insufficiency / diagnosis, mortality, surgery* Biopsy Blood Flow Velocity / physiology* Brazil / epidemiology Child Child, Preschool Echocardiography, Doppler Female Follow-Up Studies Heart Valve Prosthesis* Hospital Mortality Humans Infant Infant, Newborn Magnetic Resonance Imaging Male Middle Aged Prosthesis Design Retrospective Studies Time Factors Tomography, X-Ray Computed Transplantation, Homologous Treatment Outcome Young Adult |
| Comments/Corrections | |
Comment In:
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Ann Thorac Surg. 2010 Dec;90(6):1860-1
[PMID:
21095326
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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