Allograft Aortic Valve Replacement in the Adult: A Review

Yap, Cheng‐Hon; Yii, Michael

doi:10.1016/j.hlc.2004.01.012

Cited by 12 publications

(6 citation statements)

References 72 publications

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“…112 Reinfection of synthetic prostheses or prosthetic materials, normally employed in cases of complex endocarditis when a homograft is not used, is even more daunting and technically demanding than in reinfection of an implanted homograft. 4,23,29,66,88,89 In this context, the safety and effectiveness of Ao-H over conventional prosthesis on the recurrence of infection has been widely reported in several observational studies, 4,23,29,43,101,113,114 albeit with a difference in resistance to infection found between the valve and aortic wall of Ao-H. 108 Between 2% and 5.3% of patients with relapse or recurrence of infection following aortic valve, endocarditis surgery occur within the first year. 16,29 Recent reports showed a low recurrence of endocarditis in homograft even in complex cases with extensive injury of heart structure.…”

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confidence: 99%

Learning From Controversy: Contemporary Surgical Management of Aortic Valve Endocarditis

Nappi

Singh

Timofeeva

2020

Clin Med Insights Cardiol

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Aortic valve replacement is the commonest cardiac surgical operation performed worldwide for infective endocarditis (IE). Long-term durability and avoidance of infection relapse are goals of the procedure. However, no detailed guidelines on prosthesis selection and surgical strategies guided by the comprehensive evaluation of the extension of the infection and its microbiological characteristics, clinical profile of the patient, and risk of infection recurrence are currently available. Conventional mechanical or stented xenografts are the preferred choice for localized aortic infection. However, in cases of complex IE with the involvement of the root or the aortomitral continuity, the use of homograft is suggested according to the surgeon and center experience. Homograft use should be counterbalanced against the risk of structural degeneration. Prosthetic bioroot or prosthetic valved conduit (mechanical and bioprosthetic) are also potentially suitable alternatives. Further development of preservation techniques enabling longer durability of allogenic substitutes is required. We evaluate the current evidence for the use of valve substitutes in aortic valve endocarditis and propose an evidence-based algorithm to guide the choice of therapy. We performed a systemic review to clarify the contemporary surgical management of aortic valve endocarditis.

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Section: %mentioning

confidence: 99%

Learning From Controversy: Contemporary Surgical Management of Aortic Valve Endocarditis

Nappi

Singh

Timofeeva

2020

Clin Med Insights Cardiol

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“…With time, the various methods for allograft valve processing were observed to have divergent outcomes, with poor results observed when most sterilization methods were used (irradiation, ethylene oxide treatment, long-term maintenance in antibiotics); however, long-term outcomes with fresh and cryopreserved valves were observed to be superior. 4,23 It was speculated that maintenance of viability was therefore important in the long-term function of allograft valves. In the last 2 decades, allograft processing around the world has primarily been accomplished by cryopreservation to maintain a degree of graft viability and allow for long periods of storage.…”

Section: Historical Reports Of Allograft Durabilitymentioning

confidence: 99%

Performance of the CryoValve∗ SG human decellularized pulmonary valve in 342 patients relative to the conventional CryoValve at a mean follow-up of four years

Brown

Elkins

Clarke

et al. 2010

The Journal of Thoracic and Cardiovascular Surgery

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“…Allograft valves have the advantages of obviating anticoagulation, a low incidence of thromboembolism, optimal hemodynamics, and resistance to infective endocarditis [1]. On the other hand, allotransplantation is constrained by the availability of human donor organs.…”

Section: Introductionmentioning

confidence: 99%

Xenograft Failure of Pulmonary Valved Conduit Cross-linked with Glutaraldehyde or Not Cross-linked in a Pig to Goat Implantation Model

Kim

2012

Korean J Thorac Cardiovasc Surg

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BackgroundBiologic valved grafts are important in cardiac surgery, and although several types of graft are currently available, most commercial xenografts tend to cause early disfiguration due to intimal proliferation and calcification. We studied the graft failure patterns on non-fixed and glutaraldehyde-fixed pulmonary xenograft in vivo animal experiment.Materials and MethodsPulmonary valved conduits were obtained from the right ventricular outflow tract of eleven miniature pigs. The grafts were subjected to 2 different preservation methods; with or without glutaraldehyde fixation: glutaraldehyde fixation (n=7) and non-glutaraldehyde fixation (n=4). The processed explanted pulmonary valved grafts of miniature pig were then transplanted into eleven goats. Calcium quantization was achieved in all of the explanted xenograft, hemodynamic, histopathologic and radiologic evaluations were performed in the graft which the transplantation period was over 300 days (n=7).ResultsGrafts treated with glutaraldehyde fixation had more calcification and conduit obstruction in mid-term period. Calcium deposition also appeared much higher in the glutaraldehyde treated graft compared to the non-glutaraldehyde treated graft (p<0.05).ConclusionThe present study suggests that xenografts prepared using glutaraldehyde fixation alone appeared to have severe calcification compared to the findings of non-glutaraldehyde treated xenografts and to be managed with proper anticalcification treatment and novel preservation methods. This experiment gives the useful basic chemical, histologic data of xenograft failure model with calcification for further animal study.

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Allograft Aortic Valve Replacement in the Adult: A Review

Cited by 12 publications

References 72 publications

Learning From Controversy: Contemporary Surgical Management of Aortic Valve Endocarditis

Learning From Controversy: Contemporary Surgical Management of Aortic Valve Endocarditis

Performance of the CryoValve∗ SG human decellularized pulmonary valve in 342 patients relative to the conventional CryoValve at a mean follow-up of four years

Xenograft Failure of Pulmonary Valved Conduit Cross-linked with Glutaraldehyde or Not Cross-linked in a Pig to Goat Implantation Model

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