Decellularized versus cryopreserved pulmonary allografts for right ventricular outflow tract reconstruction during the Ross procedure: a meta-analysis of short- and long-term outcomes

Abstract Background The ideal conduit for repair of the right ventricular outflow tract (RVOT) during the Ross procedure remains unclear and has yet to be fully elucidated. We perform a pairwise meta-analysis to compare the short-term and long-term outcomes of decellularized versus cryopreserved pul...

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Autores principales:	Adham Ahmed, Sarah Ahmed, Kathryn S. Varghese, Dave M. Mathew, Roshan Pandey, Dillon O. Rogando, Stephanie A. Salazar, Peter J. Fusco, Kenneth H. Levy
Formato:	article
Lenguaje:	EN
Publicado:	SpringerOpen 2021
Materias:	Aortic valve Homograft Allograft Decellularized Ross Ross-Yacoub Diseases of the circulatory (Cardiovascular) system RC666-701
Acceso en línea:	https://doaj.org/article/801c15f7053049bab978ee77ef79252a
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spelling	oai:doaj.org-article:801c15f7053049bab978ee77ef79252a2021-11-14T12:27:23ZDecellularized versus cryopreserved pulmonary allografts for right ventricular outflow tract reconstruction during the Ross procedure: a meta-analysis of short- and long-term outcomes10.1186/s43044-021-00226-w2090-911Xhttps://doaj.org/article/801c15f7053049bab978ee77ef79252a2021-11-01T00:00:00Zhttps://doi.org/10.1186/s43044-021-00226-whttps://doaj.org/toc/2090-911XAbstract Background The ideal conduit for repair of the right ventricular outflow tract (RVOT) during the Ross procedure remains unclear and has yet to be fully elucidated. We perform a pairwise meta-analysis to compare the short-term and long-term outcomes of decellularized versus cryopreserved pulmonary allografts for RVOT reconstruction during the Ross procedure. Main body After a comprehensive literature search, studies comparing decellularized and cryopreserved allografts for patients undergoing RVOT reconstruction during the Ross procedure were pooled to perform a pairwise meta-analysis using the random-effects model. Primary outcomes were early mortality and follow-up allograft dysfunction. Secondary outcomes were reintervention rates and follow-up endocarditis. A total of 4 studies including 1687 patients undergoing RVOT reconstruction during the Ross procedure were included. A total of 812 patients received a decellularized pulmonary allograft, while 875 received a cryopreserved pulmonary allograft. Compared to cryopreserved allografts, the decellularized group showed similar rates of early mortality (odds ratio, 0.55, 95% confidence interval, 0.21–1.41, P = 0.22). At a mean follow-up period of 5.89 years, no significant difference was observed between the two groups for follow-up allograft dysfunction (hazard ratio, 0.65, 95% confidence interval, 0.20–2.14, P = 0.48). Similarly, no difference was seen in reintervention rates (hazard ratio, 0.54, 95% confidence interval, 0.09–3.12, P = 0.49) nor endocarditis (hazard ratio, 0.30, 95% confidence interval, 0.07–1.35, P = 0.12) at a mean follow-up of 4.85 and 5.75 years, respectively. Conclusions Decellularized and cryopreserved pulmonary allografts are associated with similar postoperative outcomes for RVOT reconstruction during the Ross procedure. Larger propensity-matched and randomized control trials are necessary to elucidate the efficacy of decellularized allografts compared to cryopreserved allografts in the setting of the Ross.Adham AhmedSarah AhmedKathryn S. VargheseDave M. MathewRoshan PandeyDillon O. RogandoStephanie A. SalazarPeter J. FuscoKenneth H. LevySpringerOpenarticleAortic valveHomograftAllograftDecellularizedRossRoss-YacoubDiseases of the circulatory (Cardiovascular) systemRC666-701ENThe Egyptian Heart Journal, Vol 73, Iss 1, Pp 1-8 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Aortic valve Homograft Allograft Decellularized Ross Ross-Yacoub Diseases of the circulatory (Cardiovascular) system RC666-701
spellingShingle	Aortic valve Homograft Allograft Decellularized Ross Ross-Yacoub Diseases of the circulatory (Cardiovascular) system RC666-701 Adham Ahmed Sarah Ahmed Kathryn S. Varghese Dave M. Mathew Roshan Pandey Dillon O. Rogando Stephanie A. Salazar Peter J. Fusco Kenneth H. Levy Decellularized versus cryopreserved pulmonary allografts for right ventricular outflow tract reconstruction during the Ross procedure: a meta-analysis of short- and long-term outcomes
description	Abstract Background The ideal conduit for repair of the right ventricular outflow tract (RVOT) during the Ross procedure remains unclear and has yet to be fully elucidated. We perform a pairwise meta-analysis to compare the short-term and long-term outcomes of decellularized versus cryopreserved pulmonary allografts for RVOT reconstruction during the Ross procedure. Main body After a comprehensive literature search, studies comparing decellularized and cryopreserved allografts for patients undergoing RVOT reconstruction during the Ross procedure were pooled to perform a pairwise meta-analysis using the random-effects model. Primary outcomes were early mortality and follow-up allograft dysfunction. Secondary outcomes were reintervention rates and follow-up endocarditis. A total of 4 studies including 1687 patients undergoing RVOT reconstruction during the Ross procedure were included. A total of 812 patients received a decellularized pulmonary allograft, while 875 received a cryopreserved pulmonary allograft. Compared to cryopreserved allografts, the decellularized group showed similar rates of early mortality (odds ratio, 0.55, 95% confidence interval, 0.21–1.41, P = 0.22). At a mean follow-up period of 5.89 years, no significant difference was observed between the two groups for follow-up allograft dysfunction (hazard ratio, 0.65, 95% confidence interval, 0.20–2.14, P = 0.48). Similarly, no difference was seen in reintervention rates (hazard ratio, 0.54, 95% confidence interval, 0.09–3.12, P = 0.49) nor endocarditis (hazard ratio, 0.30, 95% confidence interval, 0.07–1.35, P = 0.12) at a mean follow-up of 4.85 and 5.75 years, respectively. Conclusions Decellularized and cryopreserved pulmonary allografts are associated with similar postoperative outcomes for RVOT reconstruction during the Ross procedure. Larger propensity-matched and randomized control trials are necessary to elucidate the efficacy of decellularized allografts compared to cryopreserved allografts in the setting of the Ross.
format	article
author	Adham Ahmed Sarah Ahmed Kathryn S. Varghese Dave M. Mathew Roshan Pandey Dillon O. Rogando Stephanie A. Salazar Peter J. Fusco Kenneth H. Levy
author_facet	Adham Ahmed Sarah Ahmed Kathryn S. Varghese Dave M. Mathew Roshan Pandey Dillon O. Rogando Stephanie A. Salazar Peter J. Fusco Kenneth H. Levy
author_sort	Adham Ahmed
title	Decellularized versus cryopreserved pulmonary allografts for right ventricular outflow tract reconstruction during the Ross procedure: a meta-analysis of short- and long-term outcomes
title_short	Decellularized versus cryopreserved pulmonary allografts for right ventricular outflow tract reconstruction during the Ross procedure: a meta-analysis of short- and long-term outcomes
title_full	Decellularized versus cryopreserved pulmonary allografts for right ventricular outflow tract reconstruction during the Ross procedure: a meta-analysis of short- and long-term outcomes
title_fullStr	Decellularized versus cryopreserved pulmonary allografts for right ventricular outflow tract reconstruction during the Ross procedure: a meta-analysis of short- and long-term outcomes
title_full_unstemmed	Decellularized versus cryopreserved pulmonary allografts for right ventricular outflow tract reconstruction during the Ross procedure: a meta-analysis of short- and long-term outcomes
title_sort	decellularized versus cryopreserved pulmonary allografts for right ventricular outflow tract reconstruction during the ross procedure: a meta-analysis of short- and long-term outcomes
publisher	SpringerOpen
publishDate	2021
url	https://doaj.org/article/801c15f7053049bab978ee77ef79252a
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Decellularized versus cryopreserved pulmonary allografts for right ventricular outflow tract reconstruction during the Ross procedure: a meta-analysis of short- and long-term outcomes

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