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

被引:52
作者
Brown, John W. [1 ]
Elkins, Ronald C. [2 ]
Clarke, David R. [3 ]
Tweddell, James S. [4 ]
Huddleston, Charles B. [5 ]
Doty, John R. [6 ]
Fehrenbacher, John W. [7 ]
Takkenberg, Johanna J. M. [8 ]
机构
[1] Indiana Univ, Sch Med, Sect Cardiothorac Surg, Indianapolis, IN 46202 USA
[2] Univ Oklahoma, Hlth Sci Ctr, Oklahoma City, OK USA
[3] Childrens Hosp, Inst Heart, Denver, CO 80218 USA
[4] Childrens Hosp Wisconsin, Milwaukee, WI 53201 USA
[5] Washington Univ, St Louis Childrens Hosp, Sch Med, St Louis, MO 63110 USA
[6] Intermt Med Ctr, Salt Lake City, UT USA
[7] Methodist Hosp Indiana, Indianapolis, IN 46202 USA
[8] Erasmus MC, Rotterdam, Netherlands
关键词
OUTFLOW TRACT RECONSTRUCTION; STANDARD CRYOPRESERVED ALLOGRAFTS; AORTIC-VALVE; HOMOGRAFT VALVES; ROSS PROCEDURE; FAILURE; IMMUNOGENICITY; REPLACEMENT; DURABILITY; SYNERGRAFT;
D O I
10.1016/j.jtcvs.2009.04.065
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Objective: This study compared clinical outcomes of patients receiving CryoValve SG decellularized pulmonary valves with those of patients receiving conventionally processed CryoValve pulmonary valves. Methods: All consecutive patients undergoing Ross procedures and right ventricular outflow tract reconstructions with SG valves at 7 institutions (February 2000-November 2005) were assessed retrospectively (193 Ross procedures, 149 right ventricular outflow tract reconstructions). Patient, procedural, and outcome data were compared with those from 1246 conventional implants (665 Ross procedures, 581 right ventricular outflow tract reconstructions). Hemodynamic function was assessed at latest follow-up. Results: Follow-up was complete for 99% in SG group and 94% in conventional group, with mean follow-ups of 4.0 years (range, 0-6.7 years) for SG and 3.7 years (range, 0-6.7 years) for conventional. Five-year cumulative survivals and freedoms from adverse events were comparable between SG and conventional valves. Among patients undergoing Ross procedures, peak gradient at last follow-up was lower with SG valves (P<.01); no difference was observed in the right ventricular outflow tract reconstruction population. Pulmonary insufficiency was significantly reduced with SG valves in patients undergoing both Ross procedures (P<.01) and right ventricular outflow tract reconstructions (P<.01). Valve type was not a significant predictor of valve-related failure in propensity-adjusted analysis of either procedure. Conclusions: CryoValve SG decellularized pulmonary valves have acceptable clinical outcomes and favorably compare with conventionally processed valves. Improved hemodynamic function observed with SG valves could signify improved long-term outcomes and may be due to the decreased antigenicity of these valves. (J Thorac Cardiovasc Surg 2010; 139: 339-48)
引用
收藏
页码:339 / 348
页数:10
相关论文
共 31 条
[1]   Guidelines for reporting mortality and morbidity after cardiac valve interventions [J].
Akins, Cary W. ;
Miller, D. Craig ;
Turina, Marko I. ;
Kouchoukos, Nicholas T. ;
Blackstone, Eugene H. ;
Grunkemeier, Gary L. ;
Takkenberg, Johanna J. M. ;
David, Tirone E. ;
Butchart, Eric G. ;
Adams, David H. ;
Shahian, David M. ;
Hagl, Siegfried ;
Mayer, John E. ;
Lytle, Bruce W. .
JOURNAL OF THORACIC AND CARDIOVASCULAR SURGERY, 2008, 135 (04) :732-738
[2]   Factors in the early failure of cryopreserved homograft pulmonary valves in children: Preserved immunogenicity? [J].
Baskett, RJ ;
Ross, DB ;
Nanton, MA ;
Murphy, DA .
JOURNAL OF THORACIC AND CARDIOVASCULAR SURGERY, 1996, 112 (05) :1170-1178
[3]  
Bechtel JEM, 2008, J HEART VALVE DIS, V17, P98
[4]   Mid-term findings on echocardiography and computed tomography after RVOT-reconstruction: comparison of decellularized (SynerGraft) and conventional allografts [J].
Bechtel, JFM ;
Gellissen, J ;
Erasmi, AW ;
Petersen, M ;
Hiob, A ;
Stierle, U ;
Sievers, HH .
EUROPEAN JOURNAL OF CARDIO-THORACIC SURGERY, 2005, 27 (03) :410-415
[5]  
Bechtel JFM, 2003, J HEART VALVE DIS, V12, P734
[6]   Right ventricular outflow tract reconstruction with an allograft conduit in non-Ross patients: Risk factors for allograft dysfunction and failure [J].
Brown, JW ;
Ruzmetov, M ;
Rodefeld, MD ;
Vijay, P ;
Turrentine, MW .
ANNALS OF THORACIC SURGERY, 2005, 80 (02) :655-664
[7]   Body surface area as a predictor of aortic and pulmonary valve diameter [J].
Capps, SB ;
Elkins, RC ;
Fronk, DM .
JOURNAL OF THORACIC AND CARDIOVASCULAR SURGERY, 2000, 119 (05) :975-982
[8]   Quantification of the completeness of follow-up [J].
Clark, TG ;
Altman, DG ;
De Stavola, BL .
LANCET, 2002, 359 (9314) :1309-1310
[9]  
CLARKE DR, 1993, J THORAC CARDIOV SUR, V105, P934
[10]   Results of allograft aortic valve replacement for complex endocarditis [J].
Dearani, JA ;
Orszulak, TA ;
Schaff, HV ;
Daly, RC ;
Anderson, BJ .
JOURNAL OF THORACIC AND CARDIOVASCULAR SURGERY, 1997, 113 (02) :285-291