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Published on: March 18, 2015
Late Failure of Decellularized Cryopreserved Aortic Homograft
Fotios Kalafatakis1, Uzma Rahman2, Sriharsha Talapaneni3
1School of Medicine, University of Patras School of Medicine, Patras, Greece.
Background:
Decellularized aortic homografts were developed to reduce immunogenicity, but very long-term outcomes remain incompletely characterized.
Case Summary:
A 54-year-old woman underwent aortic root replacement with a 22-mm SynerGraft decellularized homograft for bicuspid aortic valve disease and aortic root aneurysm. Nineteen years later, she presented with acute heart failure caused by severe aortic insufficiency. Preoperative imaging demonstrated a heavily calcified retrosternal aortic root, guiding a bilateral thoracosternotomy for redo root replacement. Operative and histopathologic findings showed extensive calcific degeneration with left coronary leaflet disruption. Recovery was uneventful.
Discussion:
This case illustrates a possible very late failure pattern of a decellularized homograft and underscores the importance of meticulous preoperative imaging and individualized operative planning.
Take-Home Messages:
Decellularized aortic homografts may remain susceptible to very late structural degeneration. Careful imaging and tailored surgical planning are essential for complex redo aortic root surgery.
