Aortic Compliance After Root Replacement With Decellularized Homografts Versus in Donor Age-Matched Healthy Controls

Area of Science:

• Cardiovascular Research
• Biomaterials Science
• Medical Imaging

Background:

• Decellularized aortic homografts are used in cardiovascular surgery.
• Understanding their long-term biomechanical properties is crucial.

Purpose of the Study:

• To evaluate the compliance and blood flow of the ascending aorta in patients with decellularized aortic homografts.
• To compare these parameters with age-matched healthy controls.

Main Methods:

• Retrospective electrocardiography-gated cine balanced steady-state free precession magnetic resonance imaging was used.
• Time-resolved phase-contrast sequences assessed relative area change and pulse wave velocity for compliance.
• Maximum blood flow velocity was also determined.

Main Results:

• Patients with decellularized aortic homografts exhibited significantly lower relative area change in the proximal ascending aorta compared to controls (26% vs 38%, p < 0.001).
• Maximum blood flow velocity was significantly higher in the proximal ascending aorta of homograft patients (168 cm/s vs 115 cm/s, p = 0.009).
• No significant difference in compliance was found in the distal ascending aorta.

Conclusions:

• Decellularized aortic homografts are associated with reduced proximal ascending aorta compliance.
• This may be due to the decellularization process or graft degeneration.
• Long-term follow-up data are essential to understand the in vivo effects of these grafts.