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 allog...
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| Veröffentlicht in: | European journal of cardio-thoracic surgery 2005-03, Vol.27 (3), p.410-415 |
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| creator | Bechtel, J.F. Matthias Gellissen, Joerg Erasmi, Armin W. Petersen, Michael Hiob, Alexander Stierle, Ulrich Sievers, Hans-Hinrich |
| description | 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 |
| doi_str_mv | 10.1016/j.ejcts.2004.12.017 |
| format | Article |
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Matthias ; Gellissen, Joerg ; Erasmi, Armin W. ; Petersen, Michael ; Hiob, Alexander ; Stierle, Ulrich ; Sievers, Hans-Hinrich</creator><creatorcontrib>Bechtel, J.F. Matthias ; Gellissen, Joerg ; Erasmi, Armin W. ; Petersen, Michael ; Hiob, Alexander ; Stierle, Ulrich ; Sievers, Hans-Hinrich</creatorcontrib><description>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<0.001) which was most frequently (n=34) found in the proximal postvalvular tubular part of the conduit. Calcifications (n=11) or a fibroproliferative reaction (n=15) were rarely observed. Overall, there were no radiologic differences between the groups. On CTA, the smallest diameter of the allograft-conduits was significantly smaller than the diameter given on the cryopreservation protocol (SG=16±3a nd C=17±3 mm vs 25 mm in both groups; P<0.001 each) whereas the diameter of the distal part of the allograft was not(SG=24±2, P=0.066, and C=25±3 mm, P=0.82). Conclusions: Despite a significantshorter follow-up in the SynerGraft-group, no functional or radiologic differences were observed as compared to control-patients. The smallest diameter is located almost exclusively at the proximal level of allograft-conduits.</description><identifier>ISSN: 1010-7940</identifier><identifier>EISSN: 1873-734X</identifier><identifier>DOI: 10.1016/j.ejcts.2004.12.017</identifier><identifier>PMID: 15740948</identifier><language>eng</language><publisher>Germany: Elsevier Science B.V</publisher><subject>Adult ; Allograft ; Aortic Valve - surgery ; Bioprosthesis ; Calcification ; Computed tomography ; Cryopreservation ; Echocardiography ; Female ; Follow-Up Studies ; Graft Survival - immunology ; Heart Valve Diseases - surgery ; Heart Valve Prosthesis ; Heartvalve ; Humans ; Imaging ; Immunology ; Male ; Middle Aged ; Prosthesis Failure ; Pulmonary Valve - diagnostic imaging ; Pulmonary Valve - immunology ; Pulmonary Valve - transplantation ; Tomography, X-Ray Computed ; Transplantation, Heterologous - immunology ; Ultrasonography</subject><ispartof>European journal of cardio-thoracic surgery, 2005-03, Vol.27 (3), p.410-415</ispartof><rights>2005 Elsevier B.V. 2005</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c460t-2a16375dfc4c55ee58bcea0178a3e85132bb7c0f4d47845496b1a7a052a494693</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27903,27904</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/15740948$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Bechtel, J.F. Matthias</creatorcontrib><creatorcontrib>Gellissen, Joerg</creatorcontrib><creatorcontrib>Erasmi, Armin W.</creatorcontrib><creatorcontrib>Petersen, Michael</creatorcontrib><creatorcontrib>Hiob, Alexander</creatorcontrib><creatorcontrib>Stierle, Ulrich</creatorcontrib><creatorcontrib>Sievers, Hans-Hinrich</creatorcontrib><title>Mid-term findings on echocardiography and computed tomography after RVOT-reconstruction: comparison of decellularized (SynerGraft) and conventional allografts</title><title>European journal of cardio-thoracic surgery</title><addtitle>Eur J Cardiothorac Surg</addtitle><addtitle>Eur J Cardiothorac Surg</addtitle><description>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<0.001) which was most frequently (n=34) found in the proximal postvalvular tubular part of the conduit. Calcifications (n=11) or a fibroproliferative reaction (n=15) were rarely observed. Overall, there were no radiologic differences between the groups. On CTA, the smallest diameter of the allograft-conduits was significantly smaller than the diameter given on the cryopreservation protocol (SG=16±3a nd C=17±3 mm vs 25 mm in both groups; P<0.001 each) whereas the diameter of the distal part of the allograft was not(SG=24±2, P=0.066, and C=25±3 mm, P=0.82). Conclusions: Despite a significantshorter follow-up in the SynerGraft-group, no functional or radiologic differences were observed as compared to control-patients. The smallest diameter is located almost exclusively at the proximal level of allograft-conduits.</description><subject>Adult</subject><subject>Allograft</subject><subject>Aortic Valve - surgery</subject><subject>Bioprosthesis</subject><subject>Calcification</subject><subject>Computed tomography</subject><subject>Cryopreservation</subject><subject>Echocardiography</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Graft Survival - immunology</subject><subject>Heart Valve Diseases - surgery</subject><subject>Heart Valve Prosthesis</subject><subject>Heartvalve</subject><subject>Humans</subject><subject>Imaging</subject><subject>Immunology</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Prosthesis Failure</subject><subject>Pulmonary Valve - diagnostic imaging</subject><subject>Pulmonary Valve - immunology</subject><subject>Pulmonary Valve - transplantation</subject><subject>Tomography, X-Ray Computed</subject><subject>Transplantation, Heterologous - immunology</subject><subject>Ultrasonography</subject><issn>1010-7940</issn><issn>1873-734X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2005</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqNkcFu1DAURS0EomXgC5BQVggWCXbsxAk7VEGLWlqpFFTNxnLsl9ZDYgfbQQwfw7fW6YzKlpUt657jp3cReklwQTCp320K2KgYihJjVpCywIQ_Qoek4TTnlF0_TndMcM5bhg_QsxA2GOOalvwpOiAVZ7hlzSH6-8XoPIIfs95YbexNyJzNQN06Jb027sbL6XabSasz5cZpjqCz6MaH9z6x2eX3i6vcg3I2RD-raJx9fx-X3oSkc32mQcEwzEN6-ZMUb75uLfhjn_i3e7n9BXYh5ZDJYVg-6GN4jp70cgjwYn-u0LdPH6-OTvKzi-PPRx_OcsVqHPNSkprySveKqaoCqJpOgUwLaSSFpiK07DqucM804w2rWFt3RHKJq1KyltUtXaHXO-_k3c8ZQhSjCcvE0oKbg6g5a3CVRCtEd0HlXQgeejF5M0q_FQSLpRaxEfe1iKUWQUqRpkjUq71-7kbQ_5h9DylQ7AJunv7TmO8AEyL8fkCk_5FmTasQJ9drsT4_vyz56VpgegdvTqzG</recordid><startdate>200503</startdate><enddate>200503</enddate><creator>Bechtel, J.F. Matthias</creator><creator>Gellissen, Joerg</creator><creator>Erasmi, Armin W.</creator><creator>Petersen, Michael</creator><creator>Hiob, Alexander</creator><creator>Stierle, Ulrich</creator><creator>Sievers, Hans-Hinrich</creator><general>Elsevier Science B.V</general><scope>BSCLL</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>200503</creationdate><title>Mid-term findings on echocardiography and computed tomography after RVOT-reconstruction: comparison of decellularized (SynerGraft) and conventional allografts</title><author>Bechtel, J.F. Matthias ; Gellissen, Joerg ; Erasmi, Armin W. ; Petersen, Michael ; Hiob, Alexander ; Stierle, Ulrich ; Sievers, Hans-Hinrich</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c460t-2a16375dfc4c55ee58bcea0178a3e85132bb7c0f4d47845496b1a7a052a494693</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2005</creationdate><topic>Adult</topic><topic>Allograft</topic><topic>Aortic Valve - surgery</topic><topic>Bioprosthesis</topic><topic>Calcification</topic><topic>Computed tomography</topic><topic>Cryopreservation</topic><topic>Echocardiography</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Graft Survival - immunology</topic><topic>Heart Valve Diseases - surgery</topic><topic>Heart Valve Prosthesis</topic><topic>Heartvalve</topic><topic>Humans</topic><topic>Imaging</topic><topic>Immunology</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Prosthesis Failure</topic><topic>Pulmonary Valve - diagnostic imaging</topic><topic>Pulmonary Valve - immunology</topic><topic>Pulmonary Valve - transplantation</topic><topic>Tomography, X-Ray Computed</topic><topic>Transplantation, Heterologous - immunology</topic><topic>Ultrasonography</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Bechtel, J.F. Matthias</creatorcontrib><creatorcontrib>Gellissen, Joerg</creatorcontrib><creatorcontrib>Erasmi, Armin W.</creatorcontrib><creatorcontrib>Petersen, Michael</creatorcontrib><creatorcontrib>Hiob, Alexander</creatorcontrib><creatorcontrib>Stierle, Ulrich</creatorcontrib><creatorcontrib>Sievers, Hans-Hinrich</creatorcontrib><collection>Istex</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>European journal of cardio-thoracic surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Bechtel, J.F. Matthias</au><au>Gellissen, Joerg</au><au>Erasmi, Armin W.</au><au>Petersen, Michael</au><au>Hiob, Alexander</au><au>Stierle, Ulrich</au><au>Sievers, Hans-Hinrich</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Mid-term findings on echocardiography and computed tomography after RVOT-reconstruction: comparison of decellularized (SynerGraft) and conventional allografts</atitle><jtitle>European journal of cardio-thoracic surgery</jtitle><stitle>Eur J Cardiothorac Surg</stitle><addtitle>Eur J Cardiothorac Surg</addtitle><date>2005-03</date><risdate>2005</risdate><volume>27</volume><issue>3</issue><spage>410</spage><epage>415</epage><pages>410-415</pages><issn>1010-7940</issn><eissn>1873-734X</eissn><abstract>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<0.001) which was most frequently (n=34) found in the proximal postvalvular tubular part of the conduit. Calcifications (n=11) or a fibroproliferative reaction (n=15) were rarely observed. Overall, there were no radiologic differences between the groups. On CTA, the smallest diameter of the allograft-conduits was significantly smaller than the diameter given on the cryopreservation protocol (SG=16±3a nd C=17±3 mm vs 25 mm in both groups; P<0.001 each) whereas the diameter of the distal part of the allograft was not(SG=24±2, P=0.066, and C=25±3 mm, P=0.82). Conclusions: Despite a significantshorter follow-up in the SynerGraft-group, no functional or radiologic differences were observed as compared to control-patients. The smallest diameter is located almost exclusively at the proximal level of allograft-conduits.</abstract><cop>Germany</cop><pub>Elsevier Science B.V</pub><pmid>15740948</pmid><doi>10.1016/j.ejcts.2004.12.017</doi><tpages>6</tpages><oa>free_for_read</oa></addata></record> |
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| source | Oxford University Press Journals All Titles (1996-Current); MEDLINE; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals |
| subjects | Adult Allograft Aortic Valve - surgery Bioprosthesis Calcification Computed tomography Cryopreservation Echocardiography Female Follow-Up Studies Graft Survival - immunology Heart Valve Diseases - surgery Heart Valve Prosthesis Heartvalve Humans Imaging Immunology Male Middle Aged Prosthesis Failure Pulmonary Valve - diagnostic imaging Pulmonary Valve - immunology Pulmonary Valve - transplantation Tomography, X-Ray Computed Transplantation, Heterologous - immunology Ultrasonography |
| title | Mid-term findings on echocardiography and computed tomography after RVOT-reconstruction: comparison of decellularized (SynerGraft) and conventional allografts |
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