Autologous pulmonary valve replacement of the diseased aortic valve.

Living tissue has the potential to replace and reestablish its structure and, therefore, offers the best hope for permanent replacement of diseased cardiac valves. The autologous pulmonary valve has been used to replace the aortic valve in 97 patients since June 1967. An aortic homograft valve, and more recently an autologous conduit of fascia lata, containing a valvular structure, has been used to reconstruct the right ventricular outflow tract. Only four deaths have occurred among the last 50 patients, an 8% operative mortality. Histologic examination of valves, and 13 mo after implantation, revealed normal architecture of cells and collagen fibers with nonnal living structures. This initial experience has encouraged the authors to pursue this method of aortic valve replacement in selected cases.