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Ann Thorac Surg 1998;66:412-416
© 1998 The Society of Thoracic Surgeons

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Original articles: cardiovascular

Aortic allograft implantation techniques: pathomorphology and regurgitant jet patterns by doppler echocardiographic studies

^a Department of Cardio-Pulmonary Surgery, Thoraxcenter, University Hospital Rotterdam-Dijkzigt and Erasmus University, Rotterdam, the Netherlands
^b Department of Cardiology, Thoraxcenter, University Hospital Rotterdam-Dijkzigt and Erasmus University, Rotterdam, the Netherlands

Accepted for publication February 26, 1998.

Address reprint requests to Dr van Herwerden, Department of Cardio-Pulmonary Surgery, Bd 156, University Hospital Sophia-Dijkzigt, Dr Molewaterplein 40, 3015 GD Rotterdam, the Netherlands
e-mail: (vanherwerden{at}thch.azr.nl)

Presented at the VII International Symposium on Cardiac Bioprostheses, Sitges, Spain, June 13–15, 1997.

Background. The diagnosis of allograft-specific pathology by echocardiography has important consequences for patient counseling and research. This study describes the pathomorphologic findings and color Doppler jet patterns in a consecutive series of patients after allograft placement with either the subcoronary implantation or root replacement technique.

Methods. From 1987 to July 1996, the subcoronary allograft implantation technique and root replacement technique were used in 82 patients and 70 patients, respectively. These patients comprised the study group.

Results. The incidence of paravalvular leaks and eccentric regurgitant jets was higher with subcoronary implantation (41%) than with root replacement (11%). Patients with a subcoronary implanted allograft had a higher incidence of eccentric jets.

Conclusions. These findings support the concept of preservation of valve geometry after root replacement, as allograft-specific pathomorphologic abnormalities and eccentric jets are more common after subcoronary implantation of allografts. Learning effects, however, cannot be excluded as the cause of these abnormalities.

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