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Decellularized aortic homografts versus mechanical composite grafts for aortic root replacement.
Andreeva, Alexandra; Werner, Paul; Coti, Iuliana; Kocher, Alfred; Laufer, Guenther; Ehrlich, Marek; Zimpfer, Daniel; Andreas, Martin.
Afiliación
  • Andreeva A; Department of Cardiac Surgery, Medical University of Vienna, Vienna, Austria.
  • Werner P; Department of Cardiac Surgery, Medical University of Vienna, Vienna, Austria.
  • Coti I; Department of Cardiac Surgery, Medical University of Vienna, Vienna, Austria.
  • Kocher A; Department of Cardiac Surgery, Medical University of Vienna, Vienna, Austria.
  • Laufer G; Department of Cardiac Surgery, Medical University of Vienna, Vienna, Austria.
  • Ehrlich M; Department of Cardiac Surgery, Medical University of Vienna, Vienna, Austria.
  • Zimpfer D; Department of Cardiac Surgery, Medical University of Vienna, Vienna, Austria.
  • Andreas M; Department of Cardiac Surgery, Medical University of Vienna, Vienna, Austria.
Eur J Cardiothorac Surg ; 66(2)2024 Aug 02.
Article en En | MEDLINE | ID: mdl-39178014
ABSTRACT

OBJECTIVES:

Mechanical composite valve grafts (MCVGs) are the first-line therapy for aortic root replacement in young adults. Decellularized aortic homografts (DAH) present a promising novel alternative due to their lower thrombogenicity. We aimed to compare both treatment options regarding survival and valve-related adverse events.

METHODS:

This study was designed as a single-centre retrospective cohort study including patients who underwent root replacement with MCVG or DAH between 2000 and 2022. Urgent or emergent procedures were excluded.

RESULTS:

The study cohort included 289 patients (MCVG n = 216, DAH n = 73) with a mean age of 48.5 ± 12 years (MCVG 49 ± 12 years vs DAH 47 ± 11 years; P = 0.23) and a median EuroScore II of 1.7% (1.2, 2.6). The 30-day mortality was 1% (n = 3). Cumulative survival at 3 years was 99% for DAH and 94% for MCVG, respectively (P = 0.15). Mean follow-up was 98.9 ± 72.7 months. Bleeding events (n = 14, 6.5%) and thromboembolism (n = 14, 6.5%) were only observed in the MCVG group (P = 0.19 and 0.09, respectively). Four cases (5%) of moderate structural valve deterioration occurred, all in the DAH group (P ≤ 0.001). The cumulative incidence of a composite end point of valve-related adverse events was significantly higher in the MCVG group (P = 0.0295).

CONCLUSIONS:

Aortic root replacement with MCVGs and decellularized aortic homografts showed low mortality in an elective setting. Patients in the homograft cohort demonstrated significantly higher freedom from valve-related adverse events. DAH present a promising treatment option for young patients requiring root replacement; however, data on long-term durability are needed.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Válvula Aórtica / Prótesis Valvulares Cardíacas Límite: Adult / Female / Humans / Male / Middle aged Idioma: En Revista: Eur J Cardiothorac Surg Asunto de la revista: CARDIOLOGIA Año: 2024 Tipo del documento: Article País de afiliación: Austria Pais de publicación: Alemania
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Válvula Aórtica / Prótesis Valvulares Cardíacas Límite: Adult / Female / Humans / Male / Middle aged Idioma: En Revista: Eur J Cardiothorac Surg Asunto de la revista: CARDIOLOGIA Año: 2024 Tipo del documento: Article País de afiliación: Austria Pais de publicación: Alemania