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Decellularized Aortic Homografts: A 5-year Single Center Experience
Alexandra Andreeva, Iuliana Coti, Paul Werner, Sabine Scherzer, Günther Laufer, Alfred Kocher, Martin Andreas.
Medical University of Vienna, Vienna General Hospital, Vienna, Austria.

The aim of the current study was to analyze our single-center experience with decellularized aortic homografts (DAH) in adult patients for aortic valve replacement.


Safety, durability and hemodynamic performance was evaluated according to current guidelines in all consecutive patients who received a DAH since 03/2016.


A total of 57 patients were enrolled in the study with a mean age of 47.0 (±11.7) years, 18 (31.6%) patients were female. 8 patients (14.0%) previously underwent an intervention/surgery on aortic valve: 6 patients (10.5%) underwent valvuloplasty, one patient (1.8%) underwent an aortic valve replacement with bioprosthesis and one patient (1.8%) underwent a Ross operation. Mean diameter of the implanted DAH was 24.1 (± 2.2) mm. Mean bypass time and mean cross-clamp time were 165.6 (±58.3) min and 124.1 (± 38.4) min respectively. In 27 patients (47.4%), concomitant procedures were performed: 18 (31.6%) patients underwent a reduction plasty of ascending aorta, 5 (8.8%) patients underwent CABG surgery, 2 (3.5%) patients underwent a mitral valve reconstruction, 2 (3.5%) patients underwent pulmonary vein isolation. The maximum follow-up is 62 months; the mean follow-up is 19.0 (±21.1) months. The total follow-up is 88.8 years. The mean gradient at follow-up was 6.2 (±4.1) mmHg. No cases of non-structural dysfunction, structural degeneration, reoperation with valve explanation, valve endocarditis or thrombosis were observed. Survival and freedom from re-intervention was 100%.

Early- and mid-term results show excellent performance of DAH at our center. However, in order for this novel approach to be established as a valid alternative for aortic valve replacement in young patients, long-term data is required.

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