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The Journal of Thoracic and Cardiovascular Surgery, Vol 95, 696-704, Copyright © 1988 by The American Association for Thoracic Surgery and The Western Thoracic Surgical Association
Y Okita, G Franciosi, O Matsuki, A Robles and DN Ross
Between November 1972 and November 1986, 108 patients aged 5 to 73 years
had complete replacement of the aortic root with an aortic homograft into
which the coronary arteries were implanted. The main indications were (1) a
tunnel type of aortic obstruction involving a hypoplastic ring, (2) a
para-aortic annular abscess, (3) prosthetic valve dysfunction, mainly a
previous aortic homograft, and (4) aortic stenosis with a small aortic
anulus. Eighty-four patients (78%) had previous aortic valve operations.
Concomitant cardiac procedures were done in 34 patients (32%). The 30-day
mortality rate was 14% (15 patients). The cumulative follow-up period was
180.3 patient-years. The late mortality rate was 6.1% per patient-year (11
patients). The patients were not given anticoagulants postoperatively, but
the entire group has been completely free from thromboembolism. The
actuarial 5- year survival rate including operative deaths was 72%. The
freedom from valve-related death at 5 years after operation is 86% and
freedom from reoperation at 5 years is 96%. The use of homografts for
replacement of the aortic valve and root in patients with complex lesions
affecting these structures has shown encouraging early and late results,
with regard to both survival and valve performance.
ARTICLES
Early and late results of aortic root replacement with antibiotic- sterilized aortic homograft
National Heart Hospital, London, England.
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C. J. Knott-Craig, R. C. Elkins, P. L. Stelzer, J. D. Randolph, C. McCue, P. A. Wright, and M. M. Lane Homograft replacement of the aortic valve and root as a functional unit Ann. Thorac. Surg., June 1, 1994; 57(6): 1501 - 1506. [Abstract] [PDF]
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G. Prabhakar, N. Kumar, Z. Al-Halees, M. H. Yacoub, and C. M. G. Duran Intracardiac rupture of a false aneurysm complicating homograft reconstruction of right ventricular outflow tract J. Thorac. Cardiovasc. Surg., May 1, 1994; 107(5): 1374 - 1375. [Full Text]
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G. Gerosa, R. McKay, and D. N. Ross Replacement of the aortic valve or root with a pulmonary autograft in children Ann. Thorac. Surg., March 1, 1991; 51(3): 424 - 429. [Abstract] [PDF]
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