Fate of Aortic Valve Homografts

¹ Cora and Webb Mading Department of Surgery, Baylor University College of Medicine, and the Methodist and St. Luke's Episcopal Hospitals

Five years ago we reported that aortic valve homografts sutured into the descending thoracic aorta of the dog remained competent and continued to function if severe regurgitation of the animal's own aortic valve was created. Based on these findings human aortic valve homografts then were sutured into the descending thoracic aorta of four patients with severe aortic valve insufficiency. Recent interest in the fate of aortic valve homografts suggested need for a long-term follow-up of these four patients.

One, in whom an aortic valve homograft was substituted for a Hufnagel valve because of severe psychiatric problems produced by noise associated with the prosthesis, remained in excellent health until he was killed in an automobile accident. Two patients subsequently have required subcoronary aortic valve replacement with caged-ball prostheses, and in one of these continued competence of the aortic valve homograft more than four years after operation was proved prior to valve replacement. The fourth patient remains in excellent health and recently has been re-studied more than five years following insertion of the aortic valve homograft. These studies demonstrate continued competence of his homograft valve with no evidence of degeneration, and he remains asymptomatic.