Long-term results of valve replacement using antibiotic-sterilised homografts in the aortic position

• Published in: European journal of cardio-thoracic surgery 1996, Vol.10 (12), p.1097-1105
• Main Authors: Langley, S M, Livesey, S A, Tsang, V T, Barron, D J, Lamb, R K, Ross, J K, Monro, J L
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Aged; Aged, 80 and over; Anti-Bacterial Agents; Aortic Valve - transplantation; Child; Drug Therapy, Combination - pharmacology; Female; Follow-Up Studies; Heart Valve Diseases - surgery; Heart Valve Prosthesis Implantation - methods; Heart Valve Prosthesis Implantation - mortality; Humans; Male; Middle Aged; Postoperative Complications - mortality; Retrospective Studies; Sterilization - methods; Survival Rate; Tissue Preservation - methods; Transplantation, Homologous; Treatment Outcome
• ISSN: 1010-7940; 1873-734X
• DOI: 10.1016/S1010-7940(96)80357-5

OBJECTIVE: Antibiotic-sterilised homograft valves stored at 4 degrees Chave been implanted in the subcoronary position in this unit since 1973.This study was undertaken in order to assess the long-term function ofthese valves. METHODS: All 249 patients undergoing homograft aortic valvereplacement (AVR) at the Wessex Cardiothoracic Centre between April 1973and December 1994 were studied. Homograft valve sizes ranged from 15 mm to28 mm internal diameter, 202 (81.1%) varying between 18 mm and 22 mm. Themean patient follow-up was 12.4 years with a total follow-up of 3096patient-years. There were six early deaths (2.4%). RESULTS: On actuarialanalysis, survival was 78.5+/-2.7% (1SE) at 10 years, 65.7+/-3.3% at 15years and 55.0+/-3.9% at 20 years. The freedom from redo AVR was87.9+/-2.4% at 10 years, 71.7 +/-3.8% at 15 years and 49.7+/-5.6% at 20years. The freedom from structural degeneration was 85.6+/-2.5% at 10years, 63.6+/-4.0% at 15 years and 41.9+/-6.4% at 20 years. On multivariateanalysis the risk of valve failure was significantly higher in youngerpatients (P