The future of homografts.
The cryopreserved aortic valve is at least as satisfactory for aortic valve replacement as any known device. The future lies in fine-tuning the preservation process and sterilization. Concerning the use of allograft aortic valves as conduits, the allograft valved ascending aorta is the best conduit for the connection of right ventricle (or left ventricle) to pulmonary arteries. Availability, tailoring to size, and addition or need for composite parts remain to be developed. The allograft aorta and aortic valve may have great usefulness for replacing the aortic valve and ascending aorta in cases of aneurysms, infections, and congenitally narrowed left ventricular outflow tract; their use in these cases is yet to be increased. The future of allograft saphenous vein will involve in-vitro studies on cryopreservation toxicity, antibiotic toxicity, biochemical function of endothelial cells, and endothelial viability. Considerable in-vitro testing is necessary in both animal and human preparations. Also considered is the future of allograft small-caliber arteries--i.e., will they behave in a similar fashion to the intact internal mammary artery?--and the heart and peripheral vascular systems--i.e., are there any more spare parts?
Karp
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RB
Section of Cardiac Surgery, University of Chicago Hospitals, IL 60637.
D001021:Aortic Valve / Q000637:transplantation; D001158:Arteries / Q000637:transplantation; D005544:Forecasting; D006801:Humans; D012501:Saphenous Vein / Q000637:transplantation; D014184:Transplantation, Homologous / Q000639:trends*