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[Cryopreserved allo-grafts in aortic valve surgery]
Vestnik Rossiiskoi Akademii Meditsinskikh Nauk
|May 25, 2005
Summary
Cryopreserved aortic valve allografts offer a good quality of life without anticoagulants. The free-standing root implantation technique is recommended for better long-term results, especially in endocarditis cases.
Area of Science:
- Cardiovascular Surgery
- Cryobiology
- Tissue Engineering
Background:
- Research into cryopreservation of valve allografts resumed in 1990.
- Technology allows preparation of allografts with preserved cell reproductive capacity.
- A new technology to reduce aortic wall calcinosis was developed in 2003.
Purpose of the Study:
- To evaluate the clinical use of cryopreserved aortic valve allografts.
- To compare different implantation techniques.
- To assess long-term outcomes and complications.
Main Methods:
- 61 aortic valve replacements using cryopreserved allografts between 1992-2003.
- Implantation techniques included subcoronary, intraaortic cylinder, and free-standing root.
- Analysis of hospital mortality, survival rates, dysfunctions, reoperations, and endocarditis.
Main Results:
- Hospital mortality was 11.5% and 12-year survival was 90%.
- 44 patients developed active infective or prosthetic endocarditis.
- Dysfunctions and reoperations were less frequent with inclusion cylinder and free-standing root techniques.
Conclusions:
- Cryopreserved allografts provide good quality of life without anticoagulants and a low reinfection rate.
- The subcoronary technique should be limited; free-standing root is the preferred method, particularly for endocarditis.
- Cellular engineering may improve long-term stability of results.