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Allograft heart valve

Alireza Heidary Rouchi, Hassan Radmehr, Seyed Amirhosein Tavakoli, Tahereh Sadat Jafarzadeh Kashi, Mitra Mahdavi-Mazdeh
Durability and the rate of complications of homograft heart valves, adjusted for patient-related contributors and surgical techniques, rely mainly on the quality of allografts which in turn are mirrored in the donor characteristics and most importantly recovery and processing procedures. Aimed to assess the quality, a study was conducted to figure out the durability and late outcome following homograft replacement with valved conduits procured by the Iranian Tissue Bank. Retrospectively, the pre-implantation, perioperative and follow-up data of 400 non-consecutive recipients of cryopreserved heart valves (222 pulmonary and 178 aortic) from 2006 to 2015 were collected and analyzed in terms of variables reflecting late outcome including adverse events and durability...
August 8, 2016: Cell and Tissue Banking
T Urbanowicz, M Michalak, A Kociemba, E Straburzyńska-Migaj, S Katarzyński, S Grajek, M Jemielity
BACKGROUND: Tricuspid valve regurgitation in reported in >20% of heart recipients. It severity has not only clinical impact, but it is also associated with increased mortality. Risk factors for developing tricuspid valve dysfunction include allograft rejection, donor/recipient pericardial cavity mismatch, preoperative transpulmonary gradient and vascular resistance, biatrial anastomosis technique, and biopsy-induced injury. Tricuspid valve annulus distention is reported to causative factor for most common type of tricuspid valve dysfunction after heart transplantation...
June 2016: Transplantation Proceedings
Jean Jeudy, Allen P Burke, Aletta Ann Frazier
Lymphoma of the heart and pericardium may develop in up to 25% of patients with disseminated nodal disease, but primary cardiac lymphoma is rare. The majority are diffuse large B-cell lymphomas, which arise in immunocompetent older individuals, men twice as often as women. Subsets are found in immunocompromised patients, including those with HIV-AIDS or allograft recipients. Cardiac lymphomas tend to arise in the wall of the right heart, especially right atrium, with contiguous infiltration of epicardium and pericardium...
July 2016: Radiologic Clinics of North America
R Glenn Hepfer, Kelvin G M Brockbank, Zhen Chen, Elizabeth D Greene, Lia H Campbell, Gregory J Wright, Alyce Linthurst-Jones, Hai Yao
In regard to evaluating tissue banking methods used to preserve or otherwise treat (process) soft allograft tissue, current tests may not be sufficiently sensitive to detect potential damage inflicted before, during, and after processing. Using controlled parameters, we aim to examine the sensitivity of specific biomechanical, electrical, and biological tests in detecting mild damage to collagen. Fresh porcine pulmonary heart valves were treated with an enzyme, collagenase, and incubated using various times...
September 2016: Cell and Tissue Banking
Michele Gallo, Antonella Bonetti, Helen Poser, Filippo Naso, Tomaso Bottio, Roberto Bianco, Adolfo Paolin, Paolo Franci, Roberto Busetto, Anna Chiara Frigo, Edward Buratto, Michele Spina, Maurizio Marchini, Fulvia Ortolani, Laura Iop, Gino Gerosa
Decellularized porcine aortic valve conduits (AVCs) implanted in a Vietnamese Pig (VP) experimental animal model were matched against decellularized and then cryopreserved AVCs to assess the effect of cryopreservation on graft hemodynamic performance and propensity to in vivo repopulation by host's cells. VPs (n = 12) underwent right ventricular outflow tract substitution using AVC allografts and were studied for 15-month follow-up. VPs were randomized into two groups, receiving AVCs treated with decellularization alone (D; n = 6) or decellularization/cryopreservation (DC; n = 6), respectively...
April 26, 2016: Heart and Vessels
Simone A Huygens, Mostafa M Mokhles, Milad Hanif, Jos A Bekkers, Ad J J C Bogers, Maureen P M H Rutten-van Mölken, Johanna J M Takkenberg
Many observational studies have reported outcomes after surgical aortic valve replacement (AVR), but there are no recent systematic reviews and meta-analyses including all available bioprostheses and allografts. The objective of this study is to provide a comprehensive and up-to-date overview of the outcomes after AVR with bioprostheses and allografts reported in the last 15 years. We conducted a systematic literature review (PROSPERO register: CRD42015017041) of studies published between 2000-15. Inclusion criteria were observational studies or randomized controlled trials reporting on outcomes of AVR with bioprostheses (stented or stentless) or allografts, with or without coronary artery bypass grafting (CABG) or valve repair procedure, with study population sizen≥ 30 and mean follow-up length ≥5 years...
March 29, 2016: European Journal of Cardio-thoracic Surgery
Samir Sarikouch, Alexander Horke, Igor Tudorache, Philipp Beerbaum, Mechthild Westhoff-Bleck, Dietmar Boethig, Oleg Repin, Liviu Maniuc, Anatol Ciubotaru, Axel Haverich, Serghei Cebotari
OBJECTIVES: Decellularized homografts have shown auspicious early results when used for pulmonary valve replacement (PVR) in congenital heart disease. The first clinical application in children was performed in 2002, initially using pre-seeding with endogenous progenitor cells. Since 2005, only non-seeded, fresh decellularized allografts have been implanted after spontaneous recellularization was observed by several groups. METHODS: A matched comparison of decellularized fresh pulmonary homografts (DPHs) implanted for PVR with cryopreserved pulmonary homografts (CHs) and bovine jugular vein conduits (BJVs) was conducted...
August 2016: European Journal of Cardio-thoracic Surgery
R Díaz Rodríguez, B Van Hoeck, B Mujaj, R Ngakam, Y Fan, K Bogaerts, R Jashari
Bacteriology testing is mandatory for quality control of recovered cardiovascular allografts (CVA). In this paper, two different bacteriology examinations (A tests) performed before tissue antibiotic decontamination were compared: transport solution filtration analysis (A1) and tissue fragment direct incubation (A2). For this purpose, 521 CVA (326 heart and 195 artery tissues) from 280 donors were collected and analyzed by the European Homograft Bank (EHB). Transport solution (A1) tested positive in 43.25 % of hearts and in 48...
June 2016: Cell and Tissue Banking
James K Kirklin
PURPOSE OF REVIEW: Pediatric heart transplantation is an established therapy for end-stage cardiac disease without suitable medical or surgical options. However, transplantation for congenital heart disease carries an incremental risk that challenges the pediatric transplant team on multiple levels. RECENT FINDINGS: With improved outcomes following palliative and corrective congenital cardiac surgery, cardiac transplantation has decreased in recent years as a primary therapy...
October 2015: Current Opinion in Organ Transplantation
Nikolina Basic-Jukic, Renata Ivanac-Jankovic, Bojan Biocina, Petar Kes
UNLABELLED: Cardiovascular diseases are the major cause of morbidity and mortality in renal transplant recipients. We report our experience in the treatment of patients with renal allograft who required cardiovascular surgery. METHODS: Indications for cardiovascular surgery, postoperative complications, and outcome were recorded in a cohort of renal transplant recipients. RESULTS: Thirteen patients, five female and eight male, aged from 46 to 75 years underwent cardiac surgery after renal transplantation at University Hospital Centre Zagreb...
July 2015: Renal Failure
Luigi P Badano, Marcelo H Miglioranza, Thor Edvardsen, Alexandre Siciliano Colafranceschi, Denisa Muraru, Fernando Bacal, Koen Nieman, Giacomo Zoppellaro, Fabiana G Marcondes Braga, Thomas Binder, Gilbert Habib, Patrizio Lancellotti
The cohort of long-term survivors of heart transplant is expanding, and the assessment of these patients requires specific knowledge of the surgical techniques employed to implant the donor heart, the physiology of the transplanted heart, complications of invasive tests routinely performed to detect graft rejection (GR), and the specific pathologies that may affect the transplanted heart. A joint EACVI/Brazilian cardiovascular imaging writing group committee has prepared these recommendations to provide a practical guide to echocardiographers involved in the follow-up of heart transplant patients and a framework for standardized and efficient use of cardiovascular imaging after heart transplant...
September 2015: European Heart Journal Cardiovascular Imaging
Bernhard Michael Böll, Ferdinand Vogt, Anne Laure Boulesteix, Christoph Schmitz
OBJECTIVES: Factors influencing allograft valve failure in adult patients are still under discussion. There is evidence in heart transplantation that gender mismatching may influence patient outcome. In case of aortic valve replacement with a homograft valve, gender matching is not performed routinely. The aim of this study was to investigate the impact of gender mismatch of human aortic homografts. METHODS: Between June 1992 and August 2009, 363 adult patients received aortic or pulmonary homografts in the aortic position...
September 2015: Interactive Cardiovascular and Thoracic Surgery
Iyore A James, Tai Yi, Shuhei Tara, Cameron A Best, Alexander J Stuber, Kejal V Shah, Blair F Austin, Tadahisa Sugiura, Yong-Ung Lee, Joy Lincoln, Aaron J Trask, Toshiharu Shinoka, Christopher K Breuer
Decellularized allograft heart valves have been used as tissue-engineered heart valve (TEHV) scaffolds with promising results; however, little is known about the cellular mechanisms underlying TEHV neotissue formation. To better understand this phenomenon, we developed a murine model of decellularized pulmonary heart valve transplantation using a hemodynamically unloaded heart transplant model. Furthermore, because the hemodynamics of blood flow through a heart valve may influence morphology and subsequent function, we describe a modified loaded heterotopic heart transplant model that led to an increase in blood flow through the pulmonary valve...
September 2015: Tissue Engineering. Part C, Methods
Nastaran Shahmansouri, Raymond Cartier, Rosaire Mongrain
Surgical interventions are used to manage severe complications of heart valve diseases and to prevent the eventual rupture of an aortic aneurysm. Soft-tissue allografts, xenografts, and prosthetic grafts are used in these interventions; however, there are pre-surgical difficulties and post-surgical complications in using these grafts. One of these is the rupture potential of cryopreserved allografts at the time of transplantation and/or after the thawing process for the cryopreserved tissue. Moreover, a number of clinical observations report the patency of prosthetic grafts and aneurysm of cryopreserved allografts after the transplantation...
July 16, 2015: Journal of Biomechanics
Ulrike Böer, Ariane Schridde, Marcel Anssar, Melanie Klingenberg, Samir Sarikouch, Ansgar Dellmann, Wolfgang Harringer, Axel Haverich, Mathias Wilhelmi
BACKGROUND: The degeneration and failure of xenogeneic heart valves, such as the Matrix P Plus valve (MP-V) consisting of decellularized porcine valves (dec-pV) and equine glutaraldehyde-fixed conduits (ga-eC) have been linked to tissue immunogenicity accompanied by antibody formation. In contrast, decellularized allograft valves (dec-aV) are well-tolerated. Here, we determined tissue-specific antibody levels in patients after implantation of MP-V or dec-aV and related them to valve failure or time period after implantation...
April 2015: International Journal of Artificial Organs
Karolina Theodoridis, Igor Tudorache, Alexandru Calistru, Serghei Cebotari, Tanja Meyer, Samir Sarikouch, Christoph Bara, Ralph Brehm, Axel Haverich, Andres Hilfiker
In vivo repopulation of decellularized allografts with recipient cells leads to a positive remodeling of the graft matrix in juvenile sheep. In light of the increasing number of heart valve replacements among older patients (>65 years), this study focused on the potential for matrix-guided tissue regeneration in elderly sheep. Pulmonary valve replacement was performed in seven-year old sheep using decellularized (DV), decellularized and CCN1-coated (RV), or decellularized and in vitro reendothelialized pulmonary allografts (REV) (n=6, each group)...
June 2015: Biomaterials
Gaurav Rana, Jeffrey Shih, Nikolaos Kakouros
A 47-year-old man with history of familial cardiomyopathy and orthotopic heart transplant at the age of 34 years presented severe tricuspid stenosis (TS) with a mean transvalvular gradient of 10 mm Hg. The patient opted against tricuspid valve replacement and was offered percutaneous transcatheter tricuspid balloon valvuloplasty (PTTBV). To the best of our knowledge, this is the first report of a PTTBV in an orthotopic allograft, and demonstrates excellent clinical outcome at 1 year.
March 2015: Journal of Invasive Cardiology
Christophe J P Smeets, Philippe B Bertrand, Cristiano Spadaccio, Maud Beran, David Verhaert, Pieter M Vandervoort, Herbert Gutermann, Robert A Dion
The case is reported of a 38-year-old male patient with pulmonary homograft acute infective endocarditis and aortic root dilation that occurred 13 years after a Ross procedure for bicuspid aortic valve regurgitation. Aortic and pulmonary root replacements were performed, using a Freestyle stentless aortic root bioprosthesis in both cases, with excellent hemodynamics on postoperative echocardiography. In addition, preoperative systemic septic embolization had occurred despite an absence of left-sided endocarditis, presumably due to an intrapulmonary shunt...
May 2014: Journal of Heart Valve Disease
Gayathri Acharya, Matthew Armstrong, Chris McFall, Rachael W Quinn, Stephen L Hilbert, Gabriel L Converse, Peter B Toth, Ashley K Sherman, Chi H Lee, Gary K Lofland, Richard A Hopkins
BACKGROUND AND AIM OF THE STUDY: Native, allograft, xenograft and bioprosthetic semilunar valves are all susceptible to calcific degeneration. However, intrinsic differences in baseline calcium and phosphorus tissue concentrations within mammalian normal valve structural components (e.g., cusps, sinus, vessel wall) additionally subdivided by tripartite regions (e.g., right-, left- and non-coronary leaflets) have never been systematically measured and reported. It was originally hypothesized that variations in normative tissue concentrations of calcium and phosphorus may correspond to subsequent clinical patterns of acquired dystrophic calcification; decellularization was also expected to reduce the tissue concentrations of these elements...
May 2014: Journal of Heart Valve Disease
Kristin L Thanavaro, Daniel G Tang, Vigneshwar Kasirajan, Keyur B Shah
The total artificial heart (TAH) is effective for bridging patients with biventricular heart failure (BiVHF) to transplantation. It consists of two pneumatic pumps with four mechanical valves that replace nearly the entire myocardium, thus also making it effective therapy for heart failure from alternative (ALT) anatomical and pathophysiological causes that preclude left ventricular assist device (LVAD). This report reviews the clinical indications and outcomes for TAH implantation at our institution from 2006 to 2012...
September 2014: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
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