Aortic homograft: a suitable substitute for aortic valve replacement.
BACKGROUND
The aim of our study is to assess the results of aortic valve replacement with the aortic homograft.


METHODS
From January 1994 through September 2003, 154 patients with aortic valve disease (rheumatic = 118, nonrheumatic = 36), and a mean age of 28.8 +/- 18.2 years, underwent aortic valve replacement with an aortic homograft by the scalloped subcoronary (n = 110) or root replacement (n = 38) technique, or as a valved homograft conduit (n = 6). Associated procedures included mitral valve repair (n=30), open mitral commissurotomy (n = 22), tricuspid valve repair (n = 8), coronary artery bypass grafting (n = 6), and atrial septal defect closure (n = 1).


RESULTS
Early mortality was 7.8% (12 patients). Mean follow-up was 62 +/- 33.4 months (4 to 127 months; median, 68.5 months). One hundred and twenty-four survivors (87.3%) had no or trivial to mild aortic regurgitation. A total of six patients required reoperation for homograft dysfunction alone (n = 4), infective endocarditis (n = 1), or failure of mitral valve repair (n = 1). There were four late deaths. Actuarial and reoperation-free survival at the median follow-up were 92.2 +/- 2.2% and 95.8 +/- 1.9%, respectively. Freedom from significant aortic stenosis or regurgitation was 86.1 +/- 3.2%.


CONCLUSIONS
Aortic valve replacement with an aortic homograft can be performed with acceptable early and late mortality and provides satisfactory midterm results. We did not note any difference in homograft dysfunction and reoperation with the use of either scalloped subcoronary or root replacement technique.
Talwar
Sachin
S
Cardiothoracic Centre, All India Institute of Medical Sciences, New Delhi, India.
Mohapatra
Raghunath
R
Saxena
Anita
A
Singh
Rajvir
R
Kumar
Arkalgud Sampath
AS
D000293:Adolescent; D000328:Adult; D000368:Aged; D001021:Aortic Valve / Q000637:transplantation*; D001705:Bioprosthesis; D002648:Child; D002675:Child, Preschool; D004697:Endocarditis, Bacterial / Q000209:etiology; D005260:Female; D005500:Follow-Up Studies; D006349:Heart Valve Diseases / Q000601:surgery*; D006350:Heart Valve Prosthesis; D019918:Heart Valve Prosthesis Implantation / Q000009:adverse effects / Q000706:statistics & numerical data*; D006461:Hemolysis; D006801:Humans; D008297:Male; D008875:Middle Aged; D008944:Mitral Valve Insufficiency / Q000209:etiology / Q000473:pathology; D011475:Prosthesis Failure; D012086:Reoperation; D016019:Survival Analysis; D014184:Transplantation, Homologous; D016896:Treatment Outcome