title: Durability of homografts used to treat complex aortic valve endocarditis.
abstract: BACKGROUND
  Acute bacterial endocarditis may be extremely destructive for cardiac valves and their periannular structures. It has been suggested that complex reconstruction procedures require the use of homografts because of their versatility and potency to resist repeated infection.
  
  
  METHODS
  We studied the long-term results of 69 patients with complex endocarditis who received homografts in the aortic position.
  
  
  RESULTS
  The results after a mean follow-up of 8.1 ± 5.1 years (median, 8.0 years) showed that the recurrence of endocarditis even in these complex cases is low (7%), but the incidence of structural valve degeneration (SVD) is high. Freedom from SVD at 10 years is only 60.0%. When aortic homografts degenerate, they predominantly calcify.
  
  
  CONCLUSIONS
  The use of homografts to reconstruct endocarditis-related aortic valve destruction is associated with a low recurrence of endocarditis but a high incidence of SVD in the long run.
authors: Department of Cardiac Surgery, KU Leuven, University Hospitals Leuven, Leuven, Belgium.
authors: Willem
authors: W
authors: Flameng
authors: Department of Cardiac Surgery, KU Leuven, University Hospitals Leuven, Leuven, Belgium.
authors: Willem
authors: W
authors: Daenen
authors: European Homograft Bank, Brussels, Belgium.
authors: Ramadan
authors: R
authors: Jashari
authors: Department of Cardiac Surgery, KU Leuven, University Hospitals Leuven, Leuven, Belgium.
authors: Paul
authors: P
authors: Herijgers
authors: Department of Cardiac Surgery, KU Leuven, University Hospitals Leuven, Leuven, Belgium. Electronic address: bart.meuris@uzleuven.be.
authors: Bart
authors: B
authors: Meuris
mesh_terms: D000208:Acute Disease; D000328:Adult; D001021:Aortic Valve / Q000382:microbiology / Q000473:pathology / Q000601:surgery*; D006348:Cardiac Surgical Procedures / Q000379:methods / Q000401:mortality; D004697:Endocarditis, Bacterial / Q000382:microbiology / Q000401:mortality* / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006084:Graft Rejection; D006085:Graft Survival; D017052:Hospital Mortality; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D019651:Plastic Surgery Procedures / Q000379:methods* / Q000401:mortality; D012008:Recurrence; D012086:Reoperation; D018570:Risk Assessment; D012720:Severity of Illness Index; D015996:Survival Rate; D013718:Tensile Strength; D013997:Time Factors; D014184:Transplantation, Homologous; D016896:Treatment Outcome