Autograft or allograft aortic valve replacement in young adult patients with congenital aortic valve disease
Aims: We analysed the outcome of young adults with congenital aortic valve disease who underwent allograft or autograft aortic valve or root replacement in our institution and evaluated whether there is a preference for either valve substitute. Methods and results: Between 1987 and 2007, 169 consecutive patients with congenital aortic valve disease aged 16-55, participating in our ongoing prospective follow-up study, underwent 63 autograft and 106 allograft aortic valve replacements (AVRs). Mean age was 35 years (SD 10.8), 71% were males. Aetiology was 71% bicuspid valve, 14% other congenital, and 15% BV endocarditis. Twenty-two percent underwent previous cardiac surgery; 11% had an ascending aorta aneurysm. Two patients died in hospital. During follow-up six more patients died and 45 patients required valve-related re-operations. Thirteen-year survival was 97% for autograft and 93% for allograft recipients, 13 year freedom from valve-related re-operation was 63% for autograft and 69% for allograft patients. Conclusion: In patients with congenital aortic valve disease, autograft and allograft AVR show comparable satisfactory early and long-term results, with the increasing re-operation risk in the second decade after operation remaining a major concern.
|Keywords||Allograft, Aortic valve replacement, Autograft, Congenital aortic valve disease, Prosthetic valve selection, Young adults|
|Note||Free full text at PubMed|
|Persistent URL||dx.doi.org/10.1093/eurheartj/ehm589, hdl.handle.net/1765/29443|
Klieverik, L.M.A., Bekkers, J.A., Roos, J.W., Eijkemans, M.J.C., Raap, G.B., Bogers, A.J.J.C., & Takkenberg, J.J.M.. (2008). Autograft or allograft aortic valve replacement in young adult patients with congenital aortic valve disease. European Heart Journal, 29(11), 1446–1453. doi:10.1093/eurheartj/ehm589