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(Circulation. 1971;43:365.)
© 1971 American Heart Association, Inc.

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Use of Aortic Valve Homografts for Aortic Valve Replacement

ROBERT B. WALLACE M.D.¹; EMILIO R. GIULIANI M.D.¹; JACK L. TITUS M.D.¹

¹ From the Section of Thoracic, Cardiovascular, and General Surgery, the Division of Cardiovascular Diseases and Internal Medicine, and the Department of Experimental and Anatomic Pathology, Mayo Clinic and Mayo Foundation, Rochester, Minnesota.

One hundred sixty-nine patients underwent replacement of the aortic valve with an aortic valve homograft; of these patients 17 had concomitant commissurotomy or annuloplasty for an associated mitral valve lesion. Homografts were prepared by sterilization with beta-propiolactone solution and stored in Hanks' solution, or were prepared by sterilization with irradiation and stored at -70 C. Operative mortality was 5.3%. Thirty (19%) of the 160 surviving patients had an aortic diastolic murmur at the time of hospital dismissal, and five of these patients had hemodynamically significant homograft incompetence.

For 156 patients, follow-up was longer than 6 months; among the 147 patients who survived operation, there were 12 late deaths. Eighty-four per cent (132) of these 156 patients were alive and well 6 to 54 months after operation. Six patients have required reoperation for valve incompetence. An aortic diastolic murmur was present in 43% of patients. Five patients had significant valve incompetence; four of these patients are markedly improved over their preoperative status. Thromboembolism has been a rare complication despite the fact that anticoagulant therapy was not used. Late calcification of the homograft valve has been noted in only one patient.

Key Words: Aortic valve • Homograft preparation

Submitted on August 28, 1970
Accepted on November 6, 1970

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