Heart valve engineering: decellularized allograft matrices in clinical practice

The purpose of this review is to update the current clinical experience with tissue-engineered, nonseeded, allogenic matrices for pulmonary and aortic valve replacement. Allogenic heart valve replacement using an aortic root homograft was first performed 50 years ago on July 24, 1962, by Donald Ross at Guy's Hospital, London. Cryopreserved homografts have been the gold standard for many years in selected indications such as for pulmonary valve replacement in congenital heart disease, severe bacterial endocarditis, or for right ventricular outflow tract reconstruction during the Ross pulmonary autograft operation. However, there is evolving evidence that tissue-engineered decellularized homografts may be superior to conventional cryopreserved homografts.