Long-term function of cryopreserved aortic homografts. A ten-year study
Kirklin, J.K.; Smith, D.; Novick, W.; Naftel, D.C.; Kirklin, J.W.; Pacifico, A.D.; Nanda, N.C.; Helmcke, F.R.; Bourge, R.C.
Journal of Thoracic and Cardiovascular Surgery 106(1): 154-65; Discussion 165-6
1993
ISSN/ISBN: 0022-5223 PMID: 8320994 Document Number: 421272
Cryopreserved aortic valve homografts have become an accepted aortic valve substitute, but long-term studies with echocardiographic assessment of valve function are largely unavailable. Between 1981 and January 1, 1991, a total of 178 patients aged 9 months to 80 years (median 46 years) underwent implantation of a cryopreserved aortic valve homograft. Serial two-dimensional Doppler echocardiographic studies were obtained in 149 patients. Overall survival was 91% at 1 year and 85% at 8 years. Survival of patients undergoing isolated primary infracoronary aortic valve replacement was 99% at 1 month and 94% at 8 years. Twelve patients underwent homograft explantation. Freedom from explantation for leaflet degeneration was 95% at 8 years. Freedom from presumed leaflet failure (valve degeneration at explantation or aortic insufficiency grade 3/4 or more without reoperation on echocardiography) was 94% at 5 years and 85% at 8 years. By multivariable analysis younger recipient age was the only risk factor identified for leaflet failure. Ninety-five percent of patients followed up for 4 or more years were in New York Heart Association class I or II.