Technical aspects and outcomes of using homografts in atrioventricular valve surgery: a systematic review

Objective: To summarize and critically appraise the world experience with homografts in mitral and tricuspid valve surgery. Methods: We conducted a systematic review according to the PRISMA criteria. We searched the following terms in available databases, such as PubMed (National Center for Biotechnology Information), Cochrane Library, Web of Science (Clarivate), and Google Scholar: ((mitral homograft) OR (tricuspid homograft) OR (homograft) AND (valve replacement) OR (valve repair)). Results: We recruited 3 specialists to search the information matching our inclusion and exclusion criteria and selected 23 publications covering the period 1988-2021 for analysis. The mean follow-up period was 15 [6-60] months. Survival at the end of the follow-up period was 100% [90.7%-100.0%]; freedom from graft dysfunction was 100%, and freedom from reoperation was 100% [79%-100%]. Conclusion: The world experience with homografts in atrioventricular valve surgery is limited to small case series with inconclusive surgical aspects and a heterogeneous follow-up period. The immediate results suggest that homografts could be used as an alternative valve substitute for a wide spectrum of diseases both in primary and revision surgery.