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![]() CEBOTARI, Serghei, TUDORACHE, Igor, CIUBOTARU, Anatol, BOETHIG, Dietmar, SARIKOUCH, Samir, GOERLER, Adelheid, LICHTENBERG, Artur, CHEPTANARU, Eduard, BARNACIUC, Sergiu, CAZACU, Anatol, MALÎGA, Oxana, REPIN, Oleg, MANIUC, Liviu, BREYMANN, Thomas, HAVERICH, Axel. Use of fresh decellularized allografts for pulmonary valve replacement may reduce the reoperation rate in children and young adults: Early report. In: Circulation, 2011, vol. 124, supl. nr. 1, p. 0. ISSN 0009-7322. DOI: https://doi.org/10.1161/CIRCULATIONAHA.110.012161 |
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Circulation | ||||||
Volumul 124, Supliment nr. 1 / 2011 / ISSN 0009-7322 /ISSNe 1524-4539 | ||||||
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DOI:https://doi.org/10.1161/CIRCULATIONAHA.110.012161 | ||||||
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Background-Degeneration of xenografts or homografts is a major cause for reoperation in young patients after pulmonary valve replacement. We present the early results of fresh decellularized pulmonary homografts (DPH) implantation compared with glutaraldehyde-fixed bovine jugular vein (BJV) and cryopreserved homografts (CH). Methods and Results-Thirty-eight patients with DPH in pulmonary position were consecutively evaluated during the follow-up (up to 5 years) including medical examination, echocardiography, and MRI. These patients were matched according to age and pathology and compared with BJV (n=38) and CH (n=38) recipients. In contrast to BJV and CH groups, echocardiography revealed no increase of transvalvular gradient, cusp thickening, or aneurysmatic dilatation in DPH patients. Over time, DPH valve annulus diameters converge toward normal z-values. Five-year freedom from explantation was 100% for DPH and 86±8% and 88±7% for BJV and CH conduits, respectively. Additionally, MRI investigations in 17 DPH patients with follow-up time >2 years were compared with MRI data of 20 BJV recipients. Both patient groups (DPH and BJV) were at comparable ages (mean, 12.7±6.1 versus 13.0±3.0 years) and have comparable follow-up time (3.7±1.0 versus 2.7±0.9 years). In DPH patients, the mean transvalvular gradient was significantly (P=0.001) lower (11 mm Hg) compared with the BJV group (23.2 mm Hg). Regurgitation fraction was 14±3% and 4±5% in DPH and BJV groups, respectively. In 3 DPH recipients, moderate regurgitation was documented after surgery and remained unchanged in follow-up. Conclusions-In contrast to conventional homografts and xenografts, decellularized fresh allograft valves showed improved freedom from explantation, provided low gradients in follow-up, and exhibited adaptive growth. |
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Cuvinte-cheie alves, congenital, Heart Defects, surgery |
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<?xml version='1.0' encoding='utf-8'?> <resource xmlns:xsi='http://www.w3.org/2001/XMLSchema-instance' xmlns='http://datacite.org/schema/kernel-3' xsi:schemaLocation='http://datacite.org/schema/kernel-3 http://schema.datacite.org/meta/kernel-3/metadata.xsd'> <identifier identifierType='DOI'>10.1161/CIRCULATIONAHA.110.012161</identifier> <creators> <creator> <creatorName>Cebotari, S.</creatorName> <affiliation>Medizinische Hochschule Hannover, Germania</affiliation> </creator> <creator> <creatorName>Tudorache, I.</creatorName> <affiliation>Medizinische Hochschule Hannover, Germania</affiliation> </creator> <creator> <creatorName>Ciubotaru, A.</creatorName> <affiliation>Universitatea de Stat de Medicină şi Farmacie „Nicolae Testemiţanu“, Moldova, Republica</affiliation> </creator> <creator> <creatorName>Boethig, D.</creatorName> <affiliation>Medizinische Hochschule Hannover, Germania</affiliation> </creator> <creator> <creatorName>Sarikouch, S.</creatorName> <affiliation>Medizinische Hochschule Hannover, Germania</affiliation> </creator> <creator> <creatorName>Goerler, A.</creatorName> <affiliation>Medizinische Hochschule Hannover, Germania</affiliation> </creator> <creator> <creatorName>Lichtenberg, A.</creatorName> <affiliation>Medizinische Hochschule Hannover, Germania</affiliation> </creator> <creator> <creatorName>Cheptanaru, E.C.</creatorName> <affiliation>Universitatea de Stat de Medicină şi Farmacie „Nicolae Testemiţanu“, Moldova, Republica</affiliation> </creator> <creator> <creatorName>Barnaciuc, S.I.</creatorName> <affiliation>Universitatea de Stat de Medicină şi Farmacie „Nicolae Testemiţanu“, Moldova, Republica</affiliation> </creator> <creator> <creatorName>Cazacu, A.</creatorName> <affiliation>Universitatea de Stat de Medicină şi Farmacie „Nicolae Testemiţanu“, Moldova, Republica</affiliation> </creator> <creator> <creatorName>Malîga, O.E.</creatorName> <affiliation>Universitatea de Stat de Medicină şi Farmacie „Nicolae Testemiţanu“, Moldova, Republica</affiliation> </creator> <creator> <creatorName>Repin, O.E.</creatorName> <affiliation>Universitatea de Stat de Medicină şi Farmacie „Nicolae Testemiţanu“, Moldova, Republica</affiliation> </creator> <creator> <creatorName>Maniuc, L.</creatorName> <affiliation>Universitatea de Stat de Medicină şi Farmacie „Nicolae Testemiţanu“, Moldova, Republica</affiliation> </creator> <creator> <creatorName>Breymann, T.</creatorName> <affiliation>Medizinische Hochschule Hannover, Germania</affiliation> </creator> <creator> <creatorName>Haverich, A.</creatorName> <affiliation>Medizinische Hochschule Hannover, Germania</affiliation> </creator> </creators> <titles> <title xml:lang='en'>Use of fresh decellularized allografts for pulmonary valve replacement may reduce the reoperation rate in children and young adults: Early report</title> </titles> <publisher>Instrumentul Bibliometric National</publisher> <publicationYear>2011</publicationYear> <relatedIdentifier relatedIdentifierType='ISSN' relationType='IsPartOf'>0009-7322</relatedIdentifier> <subjects> <subject>alves</subject> <subject>congenital</subject> <subject>Heart Defects</subject> <subject>surgery</subject> </subjects> <dates> <date dateType='Issued'>2011-09-13</date> </dates> <resourceType resourceTypeGeneral='Text'>Journal article</resourceType> <descriptions> <description xml:lang='en' descriptionType='Abstract'><p>Background-Degeneration of xenografts or homografts is a major cause for reoperation in young patients after pulmonary valve replacement. We present the early results of fresh decellularized pulmonary homografts (DPH) implantation compared with glutaraldehyde-fixed bovine jugular vein (BJV) and cryopreserved homografts (CH). Methods and Results-Thirty-eight patients with DPH in pulmonary position were consecutively evaluated during the follow-up (up to 5 years) including medical examination, echocardiography, and MRI. These patients were matched according to age and pathology and compared with BJV (n=38) and CH (n=38) recipients. In contrast to BJV and CH groups, echocardiography revealed no increase of transvalvular gradient, cusp thickening, or aneurysmatic dilatation in DPH patients. Over time, DPH valve annulus diameters converge toward normal z-values. Five-year freedom from explantation was 100% for DPH and 86±8% and 88±7% for BJV and CH conduits, respectively. Additionally, MRI investigations in 17 DPH patients with follow-up time >2 years were compared with MRI data of 20 BJV recipients. Both patient groups (DPH and BJV) were at comparable ages (mean, 12.7±6.1 versus 13.0±3.0 years) and have comparable follow-up time (3.7±1.0 versus 2.7±0.9 years). In DPH patients, the mean transvalvular gradient was significantly (P=0.001) lower (11 mm Hg) compared with the BJV group (23.2 mm Hg). Regurgitation fraction was 14±3% and 4±5% in DPH and BJV groups, respectively. In 3 DPH recipients, moderate regurgitation was documented after surgery and remained unchanged in follow-up. Conclusions-In contrast to conventional homografts and xenografts, decellularized fresh allograft valves showed improved freedom from explantation, provided low gradients in follow-up, and exhibited adaptive growth.</p></description> </descriptions> <formats> <format>application/pdf</format> </formats> </resource>