Aortic Root Replacement with Homograft

Aortic homografts can be used for aortic valve replacement in congenital, rheumatic, degenerative and infective conditions, as well as failed prosthetic valves. This study was conducted to determine the midterm results of aortic valve replacement with aortic homografts . Aortic valve replacement with homografts was performed in 20 patients from February 1997 until February 2000. The valve was preferentially used in younger patients with a mean age 39.7± 1.2 years (range, 18 to 63 years). Two operative techniques were used: total aortic root replacement in 15 patients and freehand aortic valve replacement in 5 patients. We used one cryopreserved aortic allograft, and the rest were fresh allograft (17 aortic and 2 pulmonary), which were kept in a solution including an antibiotic combination with five different antibiotics. Valve function was assessed by echocardiography during the operation and in the follow-up period. There was no early mortality and one Iate death (%5). Cumulative survival was 94.7±5. 1% at 3 years. Intraoperative echocardiography disclosed no significant aortic valve incompetence. One patient (5%) required IABP in the postoperative period because of the low cardiac output syndrome. The functional capacity was normal in all patients. On postoperative echocardiography, only one patient (%5) had aortic valve incompetence. Actuarial freedom from reoperation was 95±5% at 3 years, except this patient. There were no thromboembolism and endocarditis. Actuarial freedom from valve-related complication was 95±5% at 3 years. Aortic valve replacement with homografts can be performed with low perioperative and mid-term mortality . Homograft-banks give us the opportunity to use these excellent valves for aortic valve disease. On the other hand, all aortic and pulmonary native valves of donors should be used as allograft unless they have been damaged.