Allograft? Why Choose it?

[RandyL]

What would be the reason to pick an allograft(homograft) valve over any other valve such as animal tissue or mechanical? Is there a call for this valve in certain situations? You don't hear to much about them compared to the other choices. So I say WHY a homograft?

 

[Ross]

5 years ago, you heard about it all the time and it seemed the thing to do for most people, but for various reasons, it lost it's appeal. For a long time after, we heard very little about them. Now, there seems to be resurgence in them. I don't know if it's related to medical research or if it's just normal ebb and flow with valves.

If you can get a human cadaver valve, it's in great condition and barring any complications as such, it's possible to live your life with it and there would be no additional worries about clots, bleeding, or anything associated with mechanical and tissue valves. I'm not sure of the success/failure ratio, but I've heard of many failures which prompted me to go mechanical.

Ben Smith and some of the other Ross patients may have better knowledge on this subject then I do, so I'll let them discuss it.

 

[RCB]

Pro & con

Pro & con

What would be the reason to pick an allograft(homograft) valve over any other valve such as animal tissue or mechanical? Is there a call for this valve in certain situations? You don't hear to much about them compared to the other choices. So I say WHY a homograft?

Randy,
The first recorded heart valve replacements were with homgraphs with totally different results.
Biggest Pro- hemodynamics, can't do better than a human valve.
Biggest Con. Availability- getting young health tissue of the right position, size and ready for implant is not like walking in to a butcher shop and ordering a cut of meat.

 

[RandyL]

Randy,
The first recorded heart valve replacements were with homgraphs with totally different results.
Biggest Pro- hemodynamics, can't do better than a human valve.
Biggest Con. Availability- getting young health tissue of the right position, size and ready for implant is not like walking in to a butcher shop and ordering a cut of meat.

LMAO. Sorry but that was funny to me anyways. The reason I ask this question is because my surgeon mentioned it to me. Like a fool I didn't ask why at the time and getting a hold of him is like trying to............well you know the rest. It would seem that if you could find one that fit and was healthy you would be able to get another 40-50 years out of one before my body made it calcify again.

 

[RCB]

[/COLOR]

LMAO. Sorry but that was funny to me anyways. The reason I ask this question is because my surgeon mentioned it to me. Like a fool I didn't ask why at the time and getting a hold of him is like trying to............well you know the rest. It would seem that if you could find one that fit and was healthy you would be able to get another 40-50 years out of one before my body made it calcify again.

I'm sorry, but it wasn't meant to be funny. The whole area of tranplant science faces the same problem, a shortage of donor tissue. Lots of people die every year waiting for a kidney or a heart.

Although, it varies by position, but I have never heard of anyone getting
that kind of milage out of one. Maybe you can be the first, Randy!

 

[RandyL]

Well if they don't last any longer than animal tissue, I fail to see the point then. Hard to get and not any better than what we currently have. I don't see the advantage here.

 

[RCB]

Advantages

Advantages

Well if they don't last any longer than animal tissue, I fail to see the point then. Hard to get and not any better than what we currently have. I don't see the advantage here.

Randy,
Some people say the same about Evinrude, Johnson or Mercury,
but I bet you might disagree!

 

[Kate]

Hi Randy,
I may be wrong, but I think part of the reason they aren't used much (in addition to lack of availability) is that they don't last much longer than a biological valve. I'm not sure why, but I believe that to be the case. I think they do so some benefit in people prone to endocarditis, but that's about it. Kate

 

[barbwil]

There must be someone else here who doesn't know what an allograft/homograft is. So, searching for info found what looks like a good discussion on all valves by Dr Robert Matthews.

http://www.rjmatthewsmd.com/Definitions/valves.htm

 

[ALCapshaw2]

There must be someone else here who doesn't know what an allograft/homograft is.

An allograft / homograft is a valve taken from another member of the same species (i.e. another person, typically from a recent cadaver)

Makes one wonder why they would take valves from a Donor and not the whole heart ???

Maybe from someone with Coronary Artery Disease but good valves...

'AL Capshaw'

 

[Turkey Hunter]

to agree with some of what has already been stated.
Availability can be a challenge.
With that said, the right homograph/allograph can be the perfect choice. Again, a young healthy valve can be difficult to acquire.
My second choice was homograph if the Ross couldn't be done for some reason. They had lined up a cadaver aortic that would have been fitted just fine.
Now, I chose the RP based on the same reasons RCB mentioned. "Biggest Pro- hemodynamics, can't do better than a human valve."
The difference is, they moved my own valve to the "important one"....aortic and gave me a cadaver pulmonary. My surgeon was adamant that people can even live without pulmonary valves if they have good flow through the lungs. He actually stated that using a "screen" was some-what common in his home country as a fix in younger patients for a bad pulmonary.

Choosing a valve option is a tough choice to make, yet a very personal one that I believe no one can help you make. There are negatives and positives about each. I am still on Toprol at 6 years post op. A bunch of tissue/RP patients are on no medications. Coumadin is always a consideration, but even tissue valve patients can end up on Coumadin due to Atrial flutter or fibrillation.

One thing to consider if you choose a tissue homograph, larger facilities such as CCF or Mayo do a huge amount of business with folks like cryolife and others. Remember, business is still business even when it comes to who cryolife may send the cadaver valves they have to.
i.e. a smaller hospital that does less tissue valves or a larger one that will have return business. The larger ones will probably get preferred treatment if you know what I am saying.

Hope this helps.

Ben