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European Journal of Cardio-Thoracic Surgery, Vol 10, 1097-1105, Copyright © 1996 by European Association for Cardio-thoracic Surgery
SM Langley, SA Livesey, VT Tsang, DJ Barron, RK Lamb, JK Ross and JL Monro
OBJECTIVE: Antibiotic-sterilised homograft valves stored at 4 degrees C
have been implanted in the subcoronary position in this unit since 1973.
This study was undertaken in order to assess the long-term function of
these valves. METHODS: All 249 patients undergoing homograft aortic valve
replacement (AVR) at the Wessex Cardiothoracic Centre between April 1973
and December 1994 were studied. Homograft valve sizes ranged from 15 mm to
28 mm internal diameter, 202 (81.1%) varying between 18 mm and 22 mm. The
mean patient follow-up was 12.4 years with a total follow-up of 3096
patient-years. There were six early deaths (2.4%). RESULTS: On actuarial
analysis, survival was 78.5+/-2.7% (1SE) at 10 years, 65.7+/-3.3% at 15
years and 55.0+/-3.9% at 20 years. The freedom from redo AVR was
87.9+/-2.4% at 10 years, 71.7 +/-3.8% at 15 years and 49.7+/-5.6% at 20
years. The freedom from structural degeneration was 85.6+/-2.5% at 10
years, 63.6+/-4.0% at 15 years and 41.9+/-6.4% at 20 years. On multivariate
analysis the risk of valve failure was significantly higher in younger
patients (P<0.0001) and in those who underwent aortic root tailoring (P
= 0.024). The freedom from endocarditis was 98.4+/-0.9% at 10 years,
96.2+/-1.6% at 15 years and 95.1+/-1.9% at 20 years. Of the 249 patients,
218 had an isolated homograft AVR and were not anticoagulated. In this
group there were two possible thromboembolic events. CONCLUSION: As well as
the established haemodynamic benefits, this study has shown that homograft
AVR with antibiotic-sterilised 4 degrees C stored homograft valves
implanted in the subcoronary position, offers good long-term results.
ARTICLES
Long-term results of valve replacement using antibiotic-sterilised homografts in the aortic position
Wessex Cardiothoracic Centre, Southampton General Hospital, UK.
This article has been cited by other articles:
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C. Alexiou, B. R. Keeton, A. P. Salmon, and J. L. Monro Repair of truncus arteriosus in early infancy with antibiotic sterilized aortic homografts Ann. Thorac. Surg., May 1, 2001; 71 (2007): S371 - S374. [Abstract] [Full Text] [PDF]
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 O. Lund, V. Chandrasekaran, R. Grocott-Mason, H. Elwidaa, R. Mazhar, A. Khaghani, A. Mitchell, C. Ilsley, and M. H. Yacoub PRIMARY AORTIC VALVE REPLACEMENT WITH ALLOGRAFTS OVER TWENTY-FIVE YEARS: VALVE-RELATED AND PROCEDURE-RELATED DETERMINANTS OF OUTCOME J. Thorac. Cardiovasc. Surg., January 1, 1999; 117(1): 77 - 91. [Abstract] [Full Text] [PDF]
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