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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.

OBJECTIVE:
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.

METHODS:

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

RESULTS:

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%.

CONCLUSIONS:
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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