{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,5]],"date-time":"2026-06-05T12:40:22Z","timestamp":1780663222615,"version":"3.54.1"},"reference-count":19,"publisher":"MDPI AG","issue":"6","license":[{"start":{"date-parts":[[2025,5,22]],"date-time":"2025-05-22T00:00:00Z","timestamp":1747872000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Children"],"abstract":"<jats:p>Objective: To evaluate early and midterm outcomes of cryopreserved aortic homograft implantation in pediatric patients undergoing aortic valve and root replacement. Methods: A retrospective analysis was conducted on 36 pediatric patients aged 2 to 7 years who underwent cryopreserved aortic homograft implantation between January 2016 and December 2024. Indications included complex congenital aortic valve disease, annular hypoplasia, failed Ross procedure, and infective endocarditis. The standard root replacement technique was used under moderate hypothermic cardiopulmonary bypass. Postoperative outcomes were analyzed, including early complications, mortality, echocardiographic parameters, and long-term graft performance. Statistical analyses included the use of chi-square test, the Mann\u2013Whitney U test, and Spearman correlation. Results: There was no 30-day mortality. One patient (2.8%) experienced late mortality at year 3, and two patients (5.6%) underwent reoperation at years 4 and 7 due to root aneurysm and severe regurgitation, respectively. Early postoperative echocardiography showed satisfactory hemodynamic performance with a mean gradient of 8.4 \u00b1 3.2 mmHg. At 5-year follow-up, 92.9% of grafts maintained normal function. Conclusions: Cryopreserved homografts provide a safe and effective option for pediatric aortic valve replacement in the early and midterm period. However, potential late complications such as structural degeneration or root dilation necessitate long-term surveillance. Advances in decellularized grafts may improve future durability and integration.<\/jats:p>","DOI":"10.3390\/children12060661","type":"journal-article","created":{"date-parts":[[2025,5,22]],"date-time":"2025-05-22T10:24:45Z","timestamp":1747909485000},"page":"661","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Cryopreserved Aortic Homograft Replacement in Pediatric Patients: A Single-Center Experience with Midterm Follow-Up"],"prefix":"10.3390","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4680-785X","authenticated-orcid":false,"given":"Mustafa Kemal","family":"Av\u015far","sequence":"first","affiliation":[{"name":"Department of Cardiovascular Surgery, Faculty of Medicine, \u00c7ukurova University, 01330 Adana, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yasin","family":"G\u00fczel","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Surgery, Faculty of Medicine, \u00c7ukurova University, 01330 Adana, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bar\u0131\u015f","family":"K\u0131rat","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Reanimation, Medicana International Istanbul Hospital, 34212 Istanbul, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"\u0130brahim \u00d6zg\u00fcr","family":"\u00d6nsel","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Reanimation, Medicana International Istanbul Hospital, 34212 Istanbul, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Deniz","family":"Yorganc\u0131lar","sequence":"additional","affiliation":[{"name":"Department of Thoracic Surgery, Medicana International Istanbul Hospital, 34692 Istanbul, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"\u0130lker Kemal","family":"Y\u00fccel","sequence":"additional","affiliation":[{"name":"Department of Pediatric Cardiology, Cerrahpa\u015fa Faculty of Medicine, Istanbul University, 34098 Istanbul, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cenap","family":"Zeybek","sequence":"additional","affiliation":[{"name":"Department of Pediatric Cardiology, Medipol Mega University Hospital, 34896 Istanbul, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"\u0130brahim Sava\u015f","family":"Y\u0131ld\u0131r\u0131m","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery, Medicana International Istanbul Hospital, 34520 Istanbul, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,5,22]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"3129","DOI":"10.1007\/s00431-021-04092-1","article-title":"Aortic valve surgery: Management and outcomes in the paediatric population","volume":"180","author":"Zaidi","year":"2021","journal-title":"Eur. 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Surg."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"1357","DOI":"10.1016\/j.jtcvs.2018.04.040","article-title":"Long-term outcome of cryopreserved allograft for aortic valve replacement","volume":"156","author":"Nappi","year":"2018","journal-title":"J. Thorac. Cardiovasc. Surg."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"ezae112","DOI":"10.1093\/ejcts\/ezae112","article-title":"Paediatric aortic valve replacement using decellularized allografts: A multicentre update following 143 implantations and five-year mean follow-up","volume":"65","author":"Horke","year":"2024","journal-title":"Eur. J. Cardiothorac. Surg."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"59","DOI":"10.1016\/j.athoracsur.2024.04.038","article-title":"Lifetime Management of Adolescents and Young Adults with Congenital Aortic Valve Disease","volume":"119","author":"Frankel","year":"2024","journal-title":"Ann. Thorac. 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Surg."}],"container-title":["Children"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2227-9067\/12\/6\/661\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T17:38:39Z","timestamp":1760031519000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2227-9067\/12\/6\/661"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,5,22]]},"references-count":19,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2025,6]]}},"alternative-id":["children12060661"],"URL":"https:\/\/doi.org\/10.3390\/children12060661","relation":{},"ISSN":["2227-9067"],"issn-type":[{"value":"2227-9067","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,5,22]]}}}