Key result
The use of allogenic or autologous valve substitutes is beneficial for treating aortic valve endocarditis when there is a high risk of recurrence of infection.
Why the study?
A contradiction exists between the proven benefits of aortic homografts and pulmonary autografts in aortic valve endocarditis and their very limited use in routine practice.
Does the use of allogenic or autologous tissue improve outcomes compared to conventional prostheses in patients with aortic valve endocarditis?
Does the use of allogenic or autologous tissue improve outcomes compared to conventional prostheses in patients with aortic valve endocarditis?
Allogenic or autologous tissue for aortic valve endocarditis may be beneficial in patients at high risk of recurrent infection, provided the surgery is performed at highly trained centers.
May support allogenic/autologous valves in high-recurrence-risk aortic endocarditis at expert centers; leaves open need for randomized confirmation.
The surgical treatment of aortic valve endocarditis (AVE) is generally performed using conventional mechanical or biological xenograft prosthesis, with limited use of aortic homograft (Ao-Homo) or pulmonary autograft (PA). Clinical evidence has demonstrated a clear contradiction between the proven benefits of Ao-Homo and PA in the context of infection and the very limited use of allogenic or autologous tissue in everyday clinical practice. This review aims to summarize the most recent and relevant literature in order to foster the scientific debate on the use of the use of allogenic and autologous tissue to treat AVE. The decisional process of the Heart Team should also include the preferences of the patient, his/her family, the general cardiologist or primary care physician. The use of allogenic or autologous valve substitute is beneficial if there is a high risk of recurrence of infection, avoiding extensive adhesiolysis and debridement of synthetic material. In any case, those procedures should be performed by highly trained centers to optimize outcomes.
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Nappi et al. (2019) conducted a review in Aortic valve endocarditis. Allogenic and autologous tissue (aortic homograft or pulmonary autograft) vs. Conventional mechanical or biological xenograft prosthesis was evaluated. The use of allogenic or autologous valve substitutes is beneficial for treating aortic valve endocarditis when there is a high risk of recurrence of infection.
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