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March 14, 2023Cell and Tissue BankingOpen Access

Matched comparison of decellularized homografts and bovine jugular vein conduits for pulmonary valve replacement in congenital heart disease

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Key result

Decellularized pulmonary homografts demonstrated significantly higher freedom from explantation (95.5% vs 81.7%) and degeneration (65.4% vs 39.6%) at 10 years compared to bovine jugular vein conduits.

Why the study?

Decellularized pulmonary homografts have emerged as an alternative to bovine jugular vein conduits for pulmonary valve replacement in congenital heart disease, but comparative data were needed.

Does decellularized pulmonary homograft improve freedom from explantation and endocarditis compared to bovine jugular vein conduits in patients with congenital heart disease requiring pulmonary valve replacement?

Comparison

Decellularized pulmonary homografts vs bovine jugular vein conduits

Design

Matched comparison cohort study

Follow-up

10 years

Authors

DBDmitry BobylevAHAlexander HorkeMAM. Avşar

Discussion

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Overview

Should not yet change PVR conduit choice; leaves open whether DPH superiority persists after size matching in prospective studies.

Study Design

Type

Cohort (n=638)

Multicenter

Yes

Structured PICO

Does decellularized pulmonary homograft improve freedom from explantation and endocarditis compared to bovine jugular vein conduits in patients with congenital heart disease requiring pulmonary valve replacement?

P
Population
638 patients with congenital heart disease requiring pulmonary valve replacement, matched by age group, heart defect type, and previous procedures, with a mean follow-up of 4.4 to 6.4 years.
I
Intervention
Decellularized pulmonary homografts (DPH)
C
Comparator
Bovine jugular vein conduits (BJV)
O
Outcome
Survival, freedom from endocarditis, freedom from explantation, and freedom from degeneration at 10 yearshard clinical

Main Result

Absolute Event Rate: 95.5% vs 81.7%

p-value: p=0.001

Decellularized pulmonary homografts demonstrate superior 10-year freedom from explantation, degeneration, and endocarditis compared to bovine jugular vein conduits for pulmonary valve replacement in congenital heart disease.

Limitations

  • Restrictions inherent in the matching process as a result of low numbers and high variance in congenital heart defects
  • Only retrospectively collected data was available for BJV with, at times, incomplete data in echocardiographic reports
  • BJV patients were younger to a statistically significant degree due to the upper size limit of 22 mm of BJV

Cite This Study

Bobylev et al. (2023) conducted a cohort in Congenital heart disease requiring pulmonary valve replacement (n=638). Decellularized pulmonary homografts vs. Bovine jugular vein conduits was evaluated on Freedom from explantation at 10 years (p=0.001). Decellularized pulmonary homografts demonstrated significantly higher freedom from explantation (95.5% vs 81.7%) and degeneration (65.4% vs 39.6%) at 10 years compared to bovine jugular vein conduits.

synapsesocial.com/papers/6a7efe0ee7861671be8ed375https://doi.org/10.1007/s10561-023-10082-4
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Comparison of homografts and bovine jugular vein conduits in the pulmonary position in patients <20 years of age2021 · 21 citations
  2. 2Excellent durability of homografts in pulmonary position analysed in a predefined adult group with tetralogy of Fallot†2018 · 18 citations
  3. 35-Year results from the prospective European multi-centre study on decellularized homografts for pulmonary valve replacement ESPOIR Trial and ESPOIR Registry data2022 · 30 citations
  4. 4Paediatric aortic valve replacement using decellularized allografts2020 · 26 citations
  5. 5Nationwide Registry‐Based Analysis of Infective Endocarditis Risk After Pulmonary Valve Replacement2022 · 39 citations