Eleven Year Experience of Aortic Valve Replacement with Antibiotic Sterilized Homograft Valves in Southampton

Summary

Aortic valve replacement with an antibiotic-treated aortic valve homograft was performed in 200 patients between April 1973 and December 1984. In all cases, a two-layered freehand technique of valve implantation was used. Tailoring of the annulus was performed in 39 cases and a gusset in the non-coronary sinus was used to maintain the shape of the aortic root in 67 patients. There were 6 early deaths (3 %) and 14 late deaths (7.2 %); 4 of these were related to homograft regurgitation. The 11 years survival rate on actuarial analysis was 83 %. The overall incidence of early diastolic murmurs was 27.3 %, being significantly higher in those with tailored roots (p < 0.001). Severe homograft aortic valve incompetence requiring re-operation developed in 3.1 %. Anticoagulant therapy was not used routinely, and there was no major thromboembolic episode in those who had isolated homograft aortic valve replacement. There was one case of miliary tuberculosis but pyogenic and fungal endocarditis were not encountered. No hemolysis, valvular calcification or stenosis was observed.

This series has shown excellent long-term performance of antibiotic-treated aortic homografts with a low incidence of significant postoperative regurgitation.

Key words

Aortic valve replacement - Homograft