title: Long-term function of cryopreserved aortic homografts. A ten-year study.
abstract: Cryopreserved aortic valve homografts have become an accepted aortic valve substitute, but long-term studies with echocardiographic assessment of valve function are largely unavailable. Between 1981 and January 1, 1991, a total of 178 patients aged 9 months to 80 years (median 46 years) underwent implantation of a cryopreserved aortic valve homograft. Serial two-dimensional Doppler echocardiographic studies were obtained in 149 patients. Overall survival was 91% at 1 year and 85% at 8 years. Survival of patients undergoing isolated primary infracoronary aortic valve replacement was 99% at 1 month and 94% at 8 years. Twelve patients underwent homograft explanation. Freedom from explantation for leaflet degeneration was 95% at 8 years. Freedom from presumed leaflet failure (valve degeneration at explantation or aortic insufficiency grade 3/4 or more without reoperation on echocardiography) was 94% at 5 years and 85% at 8 years. By multivariable analysis younger recipient age was the only risk factor identified for leaflet failure. Ninety-five percent of patients followed up for 4 or more years were in New York Heart Association class I or II.
authors.affiliation: Department of Surgery, University of Alabama, Birmingham 35294-0007.
authors.forename: J K
authors.initials: JK
authors.lastname: Kirklin
authors.forename: D
authors.initials: D
authors.lastname: Smith
authors.forename: W
authors.initials: W
authors.lastname: Novick
authors.forename: D C
authors.initials: DC
authors.lastname: Naftel
authors.forename: J W
authors.initials: JW
authors.lastname: Kirklin
authors.forename: A D
authors.initials: AD
authors.lastname: Pacifico
authors.forename: N C
authors.initials: NC
authors.lastname: Nanda
authors.forename: F R
authors.initials: FR
authors.lastname: Helmcke
authors.forename: R C
authors.initials: RC
authors.lastname: Bourge
mesh_terms: D000206:Actuarial Analysis; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000784:Aortic Dissection / Q000601:surgery; D001014:Aortic Aneurysm / Q000601:surgery; D001021:Aortic Valve / Q000000981:diagnostic imaging / Q000601:surgery / Q000637:transplantation*; D002648:Child; D002675:Child, Preschool; D015925:Cryopreservation; D004452:Echocardiography; D005260:Female; D005500:Follow-Up Studies; D006085:Graft Survival; D006349:Heart Valve Diseases / Q000401:mortality / Q000601:surgery; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D012086:Reoperation; D016019:Survival Analysis; D014184:Transplantation, Homologous