Evaluation of the decellularized pulmonary valve homograft (SynerGraft™)

J. F.Matthias Bechtel, Michael Müller-Steinhardt, Claudia Schmidtke, Anja Brunswik, Ulrich Stierle, Hans Hinrich Sievers

51 Citations (Scopus)


Background and aim of the study: Rejection is thought to contribute to the degeneration of valved homografts. A novel cryopreserved decellularized homograft valve (SynerGraft™; CryoLife, Inc.) offers the unique opportunity to gain new insight into the immunology of homograft implantation and its significance for valve function. Methods: Twenty-four patients (group I; mean age 37 ± 11 years) underwent implantation of a pulmonary SynerGraft and were examined at one and six months postoperatively; 22 patients (group II; mean age 41 ± 17 years) with conventional homografts served as controls. Temperature, C-reactive protein (CRP) levels and white blood cell count (WBC) were studied perioperatively. Follow up included echocardiography and anti-human leukocyte antigen (HLA) class I antibody determination. Results: Significantly lower temperatures were measured in group I (p = 0.019). CRP level and WBC each increased postoperatively, but did not differ between groups. During follow up, none of the SynerGraft patients became positive for anti-HLA antibodies, compared with 66% of controls (p = 0.011). Homograft diameter and valve orifice area were decreased significantly at one month after surgery in groups I and II (25 ± 1 versus 18 ± 3 mm; 25 ± 1 versus 19 ± 2 mm, respectively; p <0.001 both groups). Transvalvular pressure gradients significantly increased during follow up. Conclusion: Implantation of the SynerGraft pulmonary homograft appeared safe, and though evidence was found of a reduced immunologic response after SynerGraft implantation this (unexpectedly) did not translate into any hemodynamic advantage. Hence, factors other than rejection appear as the main contributions to the observed functional changes.

Original languageEnglish
JournalJournal of Heart Valve Disease
Issue number6
Pages (from-to)734-740
Number of pages7
Publication statusPublished - 11.2003


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