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Aortic valve replacement with pulmonary or aortic allografts
F M Lupinetti1, J H Lemmer, D W Ferguson
1Division of Cardiothoracic Surgery, University of Iowa School of Medicine, Iowa City.
Circulation
|November 11, 1991
Summary
Pulmonary allografts are a viable option for aortic valve replacement (AVR) when aortic allografts are unavailable. Early results show similar outcomes, suggesting pulmonary allografts can be considered in selected patients.
Area of Science:
- Cardiovascular Surgery
- Thoracic Surgery
- Transplantation Immunology
Background:
- Limited availability of aortic valve allografts necessitates exploring alternatives for aortic valve replacement (AVR).
- Pulmonary valve allografts present a potential substitute when suitable aortic allografts are scarce.
Purpose of the Study:
- To compare the early operative and postoperative outcomes of aortic valve replacement (AVR) using cryopreserved aortic allografts versus pulmonary allografts.
Main Methods:
- Retrospective analysis of 25 patients undergoing AVR between 1987-1990.
- Group 1 (n=20): Aortic allografts. Group 2 (n=5): Pulmonary allografts due to unavailability of aortic allografts.
- Follow-up included clinical evaluation, echocardiography, and computerized cine tomography.
Main Results:
- No operative or late deaths in the pulmonary allograft group (Group 2) versus one operative and two late deaths in the aortic allograft group (Group 1).
- All surviving patients were in New York Heart Association (NYHA) class I or II.
- No significant complications like false aneurysms or stenoses were observed in either group; one patient in Group 2 had mild regurgitation.
Conclusions:
- Aortic and pulmonary allografts demonstrate similar early operative and postoperative results for AVR.
- Pulmonary allografts are a suitable alternative for AVR in selected patients when appropriate aortic allografts are not available.