Related Experiment Videos
Durability of the viable aortic allograft
W W Angell1, J H Oury, J J Lamberti
1Division of Cardiac Surgery, Scripps Clinic and Research Foundation, La Jolla, CA 92037.
The Journal of Thoracic and Cardiovascular Surgery
|July 1, 1989
Summary
Unmounted viable allografts show greater durability for aortic valve replacement compared to other tissue valves. Pre-mounted allografts have a median survival of 8 years, similar to other tissue valves.
Area of Science:
- Cardiovascular Surgery
- Biomaterials Science
- Tissue Engineering
Background:
- Aortic allografts have been used for valve replacement since 1967.
- Understanding long-term structural integrity of allografts is crucial for patient outcomes.
Purpose of the Study:
- To analyze the structural deterioration and long-term durability of aortic allografts.
- To compare the performance of mounted versus unmounted allografts and different storage methods.
Main Methods:
- Analysis of 421 aortic allografts implanted since 1967.
- Evaluation of structural integrity and fibroblast viability in explanted valves.
- Comparison of valve failure times based on mounting, storage, and valve type.
Main Results:
- Unmounted viable allografts demonstrated superior durability for aortic valve replacement.
- Median time to valve failure for frozen mounted aortic valves (12.1 years) was not significantly different from fresh free-sewn valves (12.5 years).
- Pre-mounted allografts (aortic or mitral) had a median survival of 8 years, showing no enhanced durability.
Conclusions:
- The durability of unmounted viable allografts for aortic valve replacement exceeds that of other tissue valves.
- Fibroblast viability decreases over time, with acellularity observed in valves explanted after 10 years.
- Mounting status significantly impacts allograft durability, with unmounted grafts performing better.