Aortic Valve Replacement in Adult Patients with Decellularized Homografts: A Single-Center Experience

Background: decellularized aortic homografts (DAH) represent a promising alternative for aortic valve replacement in young adults due to their low immunogenicity and thrombogenicity. Herein, we report our midterm, single-center experience in adult patients with non-frozen DAH from corlife. Methods: safety, durability, and hemodynamic performance were evaluated according to current guidelines in all consecutive patients who had received a DAH at our center since 03/2016. Results: seventy-three (mean age 47 +/- 11 years, 68.4% (n = 50) male) patients were enrolled. The mean diameter of the implanted DAH was 24 +/- 2 mm. Mean follow-up was 36 +/- 27 months, with a maximum follow-up of 85 months and cumulative follow-up of 215 years. No cases of stenosis were observed, in four (5.5%) cases moderate aortic regurgitation occurred, but no reintervention was required. No cases of early mortality, non-structural dysfunction, reoperation, valve endocarditis, or thrombosis were observed. Freedom from bleeding and thromboembolic events was 100%; freedom from re-intervention was 100%; survival was 98.6% (n = 72). Conclusions: early and mid-term results showed low mortality and 100% freedom from reoperation, thromboembolic events, and bleeding at our center. However, in order for this novel approach to be established as a valid alternative to aortic valve replacement in young patients, long-term data are required.

Automated summary

This study reports the midterm results of adult patients receiving decellularized aortic homografts (DAH) for aortic valve replacement. No cases of stenosis were observed, and only 4 cases had moderate aortic regurgitation without the need for reintervention. There were no cases of early mortality, non-structural dysfunction, reoperation, valve endocarditis, or thrombosis.