The late fate of autologous fascia lata valve grafts in the aortic position.
Fascia lata has been used for aortic valve replacement in 206 patients over a period of 10 years. Important advantages of this method are easy availability of the fascia tissue, excellent valve function in the early follow-up, and the absence of thromboembolic complications and of anticoagulant therapy. Long-term follow-up revealed a 10% incidence of infective endocarditis. Late deterioration of valve function occurred in 60% of patients after an average interval of five years. Electron microscopic study of fascia lata valve cusps removed one to seven years after implantation showed no endothelial layer, but an amorphous surface coating. The tissue remained viable, but showed necrotic foci and areas of proliferation. These morphologic alterations caused thickening and sclerosis of the valve cusps, which were responsible for the late deterioration of valvular function.
D001021:Aortic Valve / Q000601:surgery*; D004697:Endocarditis, Bacterial / Q000209:etiology; D005205:Fascia / Q000637:transplantation*; D005206:Fascia Lata / Q000637:transplantation*; D005500:Follow-Up Studies; D006349:Heart Valve Diseases / Q000601:surgery*; D006801:Humans; D011183:Postoperative Complications / Q000401:mortality; D011379:Prognosis; D012008:Recurrence; D013557:Switzerland; D014182:Transplantation, Autologous