Long-term follow-up of patients with the antibiotic-sterilized aortic homograft valve inserted freehand in the aortic position.

Abstract:

:A series of 252 isolated aortic homograft valves in 248 patients have been followed for 9 to 16.5 years (mean 10.8). The valves were sterilized in antibiotic solution and stored in a nutrient medium at 4 degrees C and were nonvital. There were 15 in-hospital deaths (6%) and a mortality of 2.7% in patients undergoing an elective first operation. Actuarial survival with the study valve in situ was 57% at 10 years and 38% at 14 years. Only 8.4% of the patients died late from homograft valve failure, chiefly because of failure to refer patients with endocarditis for reoperation or because reoperation was refused in elderly, frail subjects. Incompetence was the sole cause of valve failure and was due either to valve wear or endocarditis. Significant incompetence required reoperation. On actuarial analysis, freedom from significant incompetence for the entire group was 95% at 5 years, 78% at 10 years, and 42% at 14 years. Factors increasing the risk of significant incompetence due to valve wear on multivariate analysis were increasing donor valve age (greater than or equal to 55 years), recipient age (less than 15 years), and an aortic root diameter over 30 mm. Analysis of the patient group that excluded each of these variables (low-risk group), which comprised 61% of the study population, indicated freedom from significant incompetence due to valve wear of 98% at 5 years, 94% at 9 years, and 56% at 13 years.

journal_name

Circulation

journal_title

Circulation

authors

Barratt-Boyes BG,Roche AH,Subramanyan R,Pemberton JR,Whitlock RM

doi

10.1161/01.cir.75.4.768

subject

Has Abstract

pub_date

1987-04-01 00:00:00

pages

768-77

issue

4

eissn

0009-7322

issn

1524-4539

journal_volume

75

pub_type

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