Department of Cardiovascular Surgery, İstanbul Medical Application and Research Center, Başkent University, İstanbul, Turkey.
Department of Thoracic and Cardiovascular Surgery, Faculty of Medicine, Vienna University, Vienna, Austria.
Balkan Med J. 2012 Jun;29(2):170-3. doi: 10.5152/balkanmedj.2011.017. Epub 2012 Jun 1.
The aim of this study was to analyze the midterm clinical results of aortic valve replacement with cryopreserved homografts.
Aortic valve replacement was performed in 40 patients with cryopreserved homograft. The indications were aortic valve endocarditis in 20 patients (50%), truncus arteriosus in 6 patients (15%), and re-stenosis or regurtitation after aortic valve reconstruction in 14 (35%) patients. The valve sizes ranged from 10 to 27mm. A full root replacement technique was used for homograft replacement in all patients.
The 30-day postoperative mortality rate was 12.5% (5 patients). There were four late deaths. Only one of them was related to cardiac events. Overall mortality was 22.5%. Thirty-three patients were followed up for 67±26 months. Two patients needed reoperation due to aortic aneurysm caused by endocarditis. The mean transvalvular gradient significantly decreased after valve replacement (p<0.003). The last follow up showed that the 27 (82%) patients had a normal left ventricular function.
Cryopreserved homografts are safe alternatives to mechanical valves that can be used when there are proper indications. Although it has a high perioperative mortality rate, cryopreserved homograft implantation is an alternative for valve replacement, particularly in younger patients and for complex surgical problems such as endocarditis that must be minimalized.
本研究旨在分析使用冷冻同种异体移植物进行主动脉瓣置换的中期临床结果。
对 40 例使用冷冻同种异体移植物进行主动脉瓣置换的患者进行了分析。适应证为主动脉瓣心内膜炎 20 例（50%）、动脉干 6 例（15%）和主动脉瓣重建后再狭窄或反流 14 例（35%）。瓣膜尺寸范围为 10 至 27mm。所有患者均采用全根替换技术进行同种异体移植物置换。
术后 30 天死亡率为 12.5%（5 例）。有 4 例晚期死亡。只有 1 例与心脏事件有关。总死亡率为 22.5%。33 例患者随访 67±26 个月。2 例因感染性心内膜炎引起的主动脉瘤需要再次手术。瓣膜置换后跨瓣压差明显降低（p<0.003）。最后一次随访显示，27 例（82%）患者左心室功能正常。
冷冻同种异体移植物是机械瓣膜的安全替代品，在有适当适应证的情况下可以使用。尽管围手术期死亡率较高，但冷冻同种异体移植物植入是瓣膜置换的一种替代方法，特别是在年轻患者和需要最小化的复杂手术问题如心内膜炎等情况下。
