Korean J Thorac Cardiovasc Surg.  2016 Aug;49(4):258-263. 10.5090/kjtcs.2016.49.4.258.

Long-Term Outcomes of Homografts in the Aortic Valve and Root Position: A 20-Year Experience

• Kim JY
• Kim JB
• Jung SH
• Choo SJ
• Chung CH
• Lee JW

• KMID: 2348906
• DOI: http://doi.org/10.5090/kjtcs.2016.49.4.258

Abstract

BACKGROUND
The advantages of using a homograft in valve replacement surgery are the excellent hemodynamic profile, low risk of thromboembolism, and low risk of prosthetic valve infection. The aim of this study was to evaluate the long-term outcomes of homograft implantation in the aortic valve position.
METHODS
This is a retrospective study of 33 patients (>20 years old) who underwent aortic valve replacement or root replacement with homografts between April 1995 and May 2015. Valves were collected within 24 hours from explanted hearts of heart transplant recipients (<60 years) and organ donors who were not suitable for heart transplantation. The median follow-up duration was 35.6 months (range, 0 to 168 months).
RESULTS
Aortic homografts were used in all patients. The 30-day mortality rate was 9.1%. The 1- and 5-year survival rates were 80.0%±7.3% and 60.8%±10.1%, respectively. The 1-, 5-, and 10-year freedom from reoperation rates were 92.3%±5.2%, 68.9%±10.2%, and 50.3%±13.6%, respectively. The 1-, 5-, and 10-year freedom from significant aortic dysfunction rates were 91.7%±8.0%, 41.7%±14.2%, and 25.0%±12.5%, respectively.
CONCLUSION
Homografts had the advantages of a good hemodynamic profile and low risk of thromboembolic events, and with good outcomes in cases of aortitis.

Keyword

Aortic root; Aortic valve; Homograft; Allograft

MeSH Terms

Allografts*
Aortic Valve*
Aortitis
Follow-Up Studies
Freedom
Heart
Heart Transplantation
Hemodynamics
Humans
Mortality
Reoperation
Retrospective Studies
Survival Rate
Thromboembolism
Tissue Donors
Transplant Recipients