HOMOGRAFT VALVES

Abstract

Green Lane Hospital's experience with homograft valves is presented from the commencement of the use of this technique in August, 1962, until May, 1971. With freehand aortic placement in isolated aortic valve disease, the actuarial curve, drawn from the results of follow‐up completed In the later part of 1969, showed a 69% six‐year survival rate for patients with the chemically‐treated valve, and a 79% six‐year survival rate for patients with the fresh homograft valve. The incidence of valve failure with chemically‐treated valves was 13%, the major complication being leaflet rupture. Leaflet rupture did not occur with fresh valves and 70% of these valves were functioning four to seven years after their Insertion. The current technique of antibiotic sterilization is described and discussed later. Leaflet rupture has not occurred with this graft and 95% of these valves are functioning well. A technique of mitral valve replacement on the atrial side of the mitral ring using a Teflon‐wrapped, antibiotically‐sterilized pulmonary valve is described. This technique resulted in valvular incompetence In 21% of patients, and has been superseded by the use of stent‐mounted aortic homografts for mitral replacement and of stent‐mounted pulmonary valves for tricuspid replacement. To date, the results with this technique have been good, although the follow‐up period remains short.