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European Journal of Cardio-Thoracic Surgery, Vol 6, 113-116, Copyright © 1992 by European Association for Cardio-thoracic Surgery
D Ross, M Jackson and J Davies
Between 1969 and 1991, 339 patients had an aortic valve replacement with
their own living pulmonary valve at the National Heart Hospital, Guy's
Hospital and the Harley Street Clinic, London. The longest follow- up is 24
years and cumulative follow-up is 3774 patient-years. No form of
anticoagulation was used and there were no emboli. There were 25 hospital
deaths (7.4%) but only 1 death since 1976. Late deaths occurred in 38
patients mainly from technical mal-insertion. Bacterial endocarditis
occurred in 11 patients. Thirty-eight patients were re- operated upon and
account for 15 of the late deaths. Freedom from re- operation was 85% and
the actuarial patient survival was 80% at 20 years. There has been no
evidence of primary tissue degeneration and explanted valves showed normal
cusp cellularity. Accumulating evidence suggests that the cusps not only
survive permanently but can grow with the patient making the operation
ideal for children.
ARTICLES
The pulmonary autograft--a permanent aortic valve
Harley Street Clinic, London, UK.
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N. T. Kouchoukos, V. G. Davila-Roman, T. L. Spray, S. F. Murphy, and J. B. Perrillo Replacement of the Aortic Root with a Pulmonary Autograft in Children and Young Adults with Aortic-Valve Disease N. Engl. J. Med., January 6, 1994; 330(1): 1 - 6. [Abstract] [Full Text]
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