title: The early and midterm function of decellularized aortic valve allografts.
abstract: BACKGROUND
  This study evaluates the early and midterm results of decellularized aortic valve allografts (DAVA) as an aortic valve replacement.
  
  
  METHODS
  Between October 2005 and February 2010, 41 patients, 28 of whom were male, with a median age of 34 years (range, 0.1 to 71), had aortic valve replacement with DAVA. Decellularization was obtained with a 0.1% sodium dodecyl sulfate solution. Postoperative evaluation was performed with serial echocardiograms, magnetic resonance imaging, and multislice computed tomography studies to evaluate valve hemodynamics, allograft conduit dimensions, and calcification scores.
  
  
  RESULTS
  There were 3 early deaths and 1 late death, with a mean follow-up of 19 months (range, 1 to 53). There was 1 reoperation due to a failed mitral valve repair. By echocardiography in all patients, the median immediate postoperative peak gradient was 7 mm Hg (range, 1 to 26 mm Hg), and at last follow-up it was 4 mm Hg (range, 1 to 16 mm Hg); valvular regurgitation was graded as none or trivial in all but 1 patient, who had a regurgitation graded as mild to moderate. By magnetic resonance imaging (n = 4), mean root dimensions were stable at the annulus (24 mm), sinus of Valsalva (33 mm), and sinotubular junction (28 mm). By computed tomography (n = 22), there was only discrete conduit calcification (median calcium score 63 Hounsfield units [HU]; range, 0 to 894 HU) to 3 years of follow-up. Conduit biopsy in the patient who underwent reoperation demonstrated well-preserved wall structure, absence of calcification, and limited in vivo host repopulation.
  
  
  CONCLUSIONS
  The early and midterm results with DAVA demonstrated stable structural integrity, low rate of calcification, and adequate hemodynamics. Although longer periods of observation are necessary, DAVA appears to be a promising alternative for aortic valve replacement in selected patients.
authors.affiliation: Department of Cardiac Surgery, Santa Casa de Curitiba, Pontificia Universidade Catolica do Parana, Curitiba, Paraná, Brazil. fcosta13@mac.com
authors.forename: Francisco D A
authors.initials: FD
authors.lastname: da Costa
authors.forename: Ana Claudia B A
authors.initials: AC
authors.lastname: Costa
authors.forename: Roberta
authors.initials: R
authors.lastname: Prestes
authors.forename: Ana Carolina
authors.initials: AC
authors.lastname: Domanski
authors.forename: Eduardo Mendel
authors.initials: EM
authors.lastname: Balbi
authors.forename: Andreia D A
authors.initials: AD
authors.lastname: Ferreira
authors.forename: Sergio Veiga
authors.initials: SV
authors.lastname: Lopes
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001021:Aortic Valve / Q000503:physiopathology / Q000637:transplantation*; D001022:Aortic Valve Insufficiency / Q000175:diagnosis / Q000401:mortality / Q000601:surgery*; D001706:Biopsy; D001783:Blood Flow Velocity / Q000502:physiology*; D001938:Brazil / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D015150:Echocardiography, Doppler; D005260:Female; D005500:Follow-Up Studies; D006350:Heart Valve Prosthesis; D017052:Hospital Mortality; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D011474:Prosthesis Design; D012189:Retrospective Studies; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D014184:Transplantation, Homologous; D016896:Treatment Outcome; D055815:Young Adult