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Standardized Technique of Aortic Valve Re-implantation for Valve-sparing Aortic Root Replacement
Published on: December 11, 2017
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Aortic valve homograft: 10-year experience
Francesco Nappi1, Nawwar Al-Attar2, Cristiano Spadaccio3
1Centre Cardiologique du Nord St. Denis, France.
Surgical Technology International
|April 5, 2014
Summary
Aortic valve homografts, while widely used, face durability issues due to cryopreservation. Fresh allografts show better outcomes, but structural deterioration remains a concern, particularly in younger patients.
Area of Science:
- Cardiology
- Thoracic Surgery
- Biomedical Engineering
Background:
- Aortic valve homografts have been used since 1962, with over 25,000 implanted globally.
- Cryopreservation of homografts can lead to fibrosis and calcification, impacting long-term durability.
- Fresh allografts may offer superior valve durability compared to cryopreserved counterparts.
Purpose of the Study:
- To report on the clinical experience with 210 aortic homografts implanted over a decade.
- To evaluate the durability and outcomes of aortic valve homografts.
- To identify predictors of reoperation and mortality in patients receiving aortic homografts.
Main Methods:
- Review of 210 aortic homograft implantations over a 10-year period.
- Description of various implantation techniques, focusing on homograft root replacement.
- Analysis of structural valve deterioration, reoperation rates, and mortality.
Main Results:
- Approximately 25% of aortic homografts experience structural valve deterioration by 12 years post-implantation.
- Deterioration primarily manifests as aortic insufficiency, less commonly as stenosis.
- Young recipient age is identified as a significant determinant for reoperation.
Conclusions:
- Aortic valve homograft durability remains a challenge, with structural deterioration occurring in a notable proportion of patients.
- Homograft root replacement is a key implantation technique.
- Recipient age is a critical factor influencing the need for reoperation after homograft implantation.
