Mid-term findings on echocardiography and computed tomography after RVOT-reconstruction: comparison of decellularized (SynerGraft) and conventional allografts

Objective: The immune response against human-leucocyte-antigens on donor-cells may be an important factor contributing to the degeneration of allograft-valves. We have previously reported that the use of the decellularized allograft SynerGraft(CryoLife®) reduces the immunologic response of the allograft-recipient. In this study we compare the echocardiographic and computedtomography angiographic (CTA) findings of SynerGrafts with conventional cryopreserved allografts. Methods: 22 patients who received a pulmonary SynerGraft (SG-group) (21 during a Ross-procedure) underwent CTA and resting echocardiography (median: 10 months postoperatively). 47 randomly chosen patients who underwent a Ross-procedure served as controls (C-group) (median: 32 months postoperatively). Results: Neither the pressure gradients (mean: SG=9±4 vs C=10±4 mmHg; P=0.64) across the allograft, nor the effective orifice area (EOAI)(SG=0.93±0.80 vs C=0.93±0.42cm2/m2; P=0.96) differed between the groups. The EOAI showed a significant correlation with the smallest allograft-conduit-area measured on CTA (r=0.81; P