Document Detail


The early and midterm function of decellularized aortic valve allografts.
MedLine Citation:
PMID:  21095325     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
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:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  The Annals of thoracic surgery     Volume:  90     ISSN:  1552-6259     ISO Abbreviation:  Ann. Thorac. Surg.     Publication Date:  2010 Dec 
Date Detail:
Created Date:  2010-11-24     Completed Date:  2011-01-18     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  15030100R     Medline TA:  Ann Thorac Surg     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  1854-60     Citation Subset:  AIM; IM    
Copyright Information:
Copyright © 2010 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.
Affiliation:
Department of Cardiac Surgery, Santa Casa de Curitiba, Pontificia Universidade Catolica do Parana, Curitiba, Paraná, Brazil. fcosta13@mac.com
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MeSH Terms
Descriptor/Qualifier:
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:
Ann Thorac Surg. 2010 Dec;90(6):1860-1   [PMID:  21095326 ]

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


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