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March 1, 1987Journal of Cardiac Surgery155 citations

The Viable Cryopreserved Allograft Aortic Valve

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MOMark F. O’BrienGSGregory StaffordMGM. Gardner

Key Result

Aortic valve replacement with a viable cryopreserved allograft valve eliminated reoperation for leaflet perforation or rupture compared to nonviable valves (0% vs 18.5%; p<0.0001).

Study Design

Type

Cohort (n=308)

Structured PICO

Does a viable cryopreserved aortic allograft valve reduce reoperation for leaflet perforation or rupture compared to a nonviable refrigerated allograft in patients undergoing aortic valve replacement?

P
Population
308 patients undergoing aortic valve replacement (184 in viable cryopreserved era, 124 in nonviable refrigerated era)
I
Intervention
Viable cryopreserved aortic allograft valve
C
Comparator
Nonviable 4 degrees C refrigerated aortic allograft valve
O
Outcome
Reoperation for leaflet perforation or rupturehard clinical

Viable cryopreserved aortic allograft valves offer significantly improved durability over nonviable refrigerated allografts, with zero reoperations for leaflet perforation or rupture up to 11 years.

Main Result

Absolute Event Rate: 0% vs 18.5%

p-value: p=<0.0001

Abstract

One hundred and twenty-four patients underwent aortic valve replacement with a nonviable 4 degrees C refrigerated aortic allograft valve. One hundred and eighty-four patients underwent aortic valve replacement with a viable cryopreserved aortic allograft valve in a later era. The longest follow-up was 16 years for the group with the nonviable valve and 11 years for the group with the viable valves. Within this time frame, reoperation was required in 23 patients with nonviable valves for leaflet perforation or rupture whereas no patients in the group with viable valves developed this complication (p less than 0.0001). The prevalence of endocarditis and thromboembolism was very low in both groups. Viability of leaflet tissue is associated with an important improvement in durability over nonviable allograft valves. Consequently, long-term follow-up results of allograft valves might be best expressed in terms of viability. The current evidence suggests that the viable cells are donor in origin. The viable cryopreserved aortic allograft valve offers significant advantages over current nonviable allograft valves, mechanical valves, and bioprostheses.

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Cite This Study

O’Brien et al. (1987) conducted a cohort in Aortic valve disease requiring replacement (n=308). Viable cryopreserved aortic allograft valve vs. Nonviable 4 degrees C refrigerated aortic allograft valve was evaluated on Reoperation for leaflet perforation or rupture (p=<0.0001). Aortic valve replacement with a viable cryopreserved allograft valve eliminated reoperation for leaflet perforation or rupture compared to nonviable valves (0% vs 18.5%; p<0.0001).

synapsesocial.com/papers/6a0ccbd5291fe4aa62625586https://doi.org/10.1111/jocs.1987.2.1s.153
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