[Use of aortic valve homografts in adults].
Although the first implantations of homologous aortic valve grafts were performed many years ago, there has been a recent renewed interest in these valve replacements particularly as a result of progress in cryopreservation techniques and the development of homograft banks. Homografts have many advantages: low incidence of thromboembolic complications, no need for anticoagulant treatment, excellent haemodynamic performance and resistance to infection which make them the valve replacement of choice in the case of endocarditis, particularly in the presence of an abscess of the aortic cuff. However, their disadvantages concern their limited availability, a more difficult operative technique, a risk of postoperative aortic incompetence and the possibility of long-term degeneration. However, the most recent studies show that homografts have a longer life-span than bioprostheses, particularly in young subjects in whom 70% of cryopreserved homografts remain free of degeneration after 15 years. If these encouraging results are confirmed, implantation of a homograft could be considered to be an alternative to valve replacement by mechanical prosthesis in this age group. Other studies, especially comparative studies versus mechanical prostheses, are required in order to extend the indications of homograft aortic valves.
Habib
G
G
Service de Cardiologie B, Hôpital de la Timone, Marseille.
Kreitmann
B
B
D000328:Adult; D001021:Aortic Valve / Q000637:transplantation*; D004452:Echocardiography; D006801:Humans; D013997:Time Factors