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Abstract
Background. Complex aortic valve and root pathology presents a serious operative challenge.
Methods. During the last 45 months 21 cryopreserved homograft root replacements have been
performed in 19 patients. The ages of the patients ranged from 28 to 77 years; there
were 15 men and four women. Six patients had endocarditis, four prosthetic and two
native valve endocarditis. One patient underwent homograft aortic root replacement
twice; one underwent concomitant homograft right ventricular outflow tract reconstruction
for pulmonic endocarditis. Causes of aortic pathology in the other 13 patients included
ascending aortic aneurysm with valvular regurgitation in seven, Marfan syndrome in
two, and four aortic dissections with aortic regurgitation. Ten of the nineteen patients
were undergoing reoperative procedures.
Results. There were three hospital deaths and one death at home of unknown cause. Two of the
three patients who died in hospital had undergone redo cardiac procedures. Dramatic
functional class improvement was seen in all survivors.
Conclusions. Follow-up from 2 to 45 months in the fifteen survivors revealed no clinical or significant
echocardiographic evidence of valvular regurgitation or recurrent infection. We believe
homograft root replacement provides an excellent method of reconstruction with several
advantages unique to human valved conduits, including ease of handling, lack of synthetic
nidus for recurrent infection, and absence of thrombogenic materials. Homografts should
be considered the approach of choice in complex valvular and root infectious processes.
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References
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Article info
Footnotes
☆Presented at the Fiftieth Annual Meeting of the Central Surgical Association, Cincinnati, Ohio, March 4–6, 1993.
Identification
Copyright
© 1993 Published by Elsevier Inc.
