Document Detail

Long-term results of aortic valve replacement with nonviable homografts.
MedLine Citation:
PMID:  1934447     Owner:  NLM     Status:  MEDLINE    
Between 1965 and 1972, 250 patients (186 men and 64 women; median age, 48 years) underwent aortic valve replacement with homografts preserved with beta-propiolactone (98 patients) or irradiation (152 patients); operative mortality was 6% (15 patients). Follow-up to death, reoperation, or recent evaluation was completed in 95% of patients, and median follow-up time was 11.4 years. Thromboembolic events occurred in two patients (0.21 events/100 patients/yr). Risk of reoperation was 22% at 5 years, 62% at 10 years, 85% at 15 years, and 95% at 20 years. Factors associated with increased risk of reoperation were young age, male sex, native aortic valve insufficiency, previous aortic valve surgery, history of endocarditis, and larger homograft size. Survival at 5, 10, 15, and 20 years was 85%, 66%, 53%, and 38%, respectively. Late survival was diminished in older patients and those with native aortic valve insufficiency and coronary artery disease. Aortic valve replacement with nonviable homografts has a high risk of late tissue degeneration and need for reoperation. However, the incidence of thromboemboli is minimal, and grafts can be replaced with low risk (4.5%) so that overall patient survival is similar to that observed with other bioprosthetic or mechanical heart valves.
R C Daly; T A Orszulak; H V Schaff; E McGovern; R B Wallace
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Circulation     Volume:  84     ISSN:  0009-7322     ISO Abbreviation:  Circulation     Publication Date:  1991 Nov 
Date Detail:
Created Date:  1991-12-16     Completed Date:  1991-12-16     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0147763     Medline TA:  Circulation     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  III81-8     Citation Subset:  AIM; IM    
Division of Thoracic and Cardiovascular Surgery, Mayo Clinic, Rochester, MN 55905.
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MeSH Terms
Actuarial Analysis
Aortic Valve / transplantation*
Aortic Valve Insufficiency / surgery*
Aortic Valve Stenosis / surgery*
Hospital Mortality
Middle Aged
Postoperative Complications / epidemiology
Risk Factors
Survival Rate
Thromboembolism / epidemiology
Time Factors
Transplantation, Homologous

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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