Improved Results Using Decellularized Human Valves for Children with Congenital Heart Defects

Operative mortality of children with congenital heart defects has decreased substantially in the past decade, thereby leading to increasing reoperations and increased valve replacement need. Within this article we want to summarize the mid-term clinical results of nonseeded decellularized homografts, deriving from donated human heart valves. So far, the most common therapeutic options for valve replacement in children have been either a biological valve replacement, which undergoes degenerative processes, or a mechanical valve replacement, which requires lifelong anticoagulation. Decellularized pulmonary homografts showed superior results for both, freedom from explantation and infective endocarditis in a direct matched comparison to other available therapeutic options, such as bovine jugular vein conduits or conventional cryopreserved homografts. Decellularized homografts have been also used for aortic valve replacement in young patients and shown encouraging early results. Therefore decellularized homografts constitute a new therapeutic option for children and adults with congenital heart defects.