Long-term outcome of cryopreserved allograft for aortic valve replacement. Academic Article uri icon

Overview

abstract

  • OBJECTIVE: The most efficient surgical approach to severe aortic valve disease in the young adult is still debated: cryopreserved aortic allograft offers excellent hemodynamic and avoid anticoagulation, but long-term durability is influenced by structural valve deterioration (SVD). This study aimed to describe long-term results of aortic allografts and to identify factors influencing long-term durability. METHODS: From January 1993 to August 2010, 210 patients underwent aortic allograft replacement via the free-hand subcoronary implantation technique (N = 55) or root replacement with coronary reimplantation (N = 155). Clinic and echocardiographic follow-up was updated to April 2016. RESULTS: Overall mortality and cardiac mortality occurred in 80 (38.1%) and 64 (30.5%) patients, respectively. Reoperation was required in 69 cases (32.8%), whereas SVD required reoperation in 57 cases (27.1%). No early endocarditis occurred, whereas late endocarditis occurred in 4 patients. The free-hand technique seems to be associated with improved left ventricular remodeling compared with the root-replacement technique, and smaller allograft size represents a predictor of reoperation independently on the surgical technique used. In the overall population, there were 44 women of childbearing age, and 37 patients remained pregnant during the follow-up of the study. No differences were found in the clinical outcomes among women who had children and who did not. CONCLUSIONS: Cryopreserved allograft is a valid option, especially in complex infective endocarditis and in women of childbearing age. A careful choice of allograft size and implantation technique can reduce the risk of SVD.

publication date

  • April 18, 2018

Research

keywords

  • Aortic Valve
  • Cryopreservation
  • Heart Valve Prosthesis Implantation

Identity

Scopus Document Identifier

  • 85046880391

Digital Object Identifier (DOI)

  • 10.1016/j.jtcvs.2018.04.040

PubMed ID

  • 29759737

Additional Document Info

volume

  • 156

issue

  • 4