Bacterial endocarditis following homograft replacement of the aortic valve.

Endocarditis was encountered on an aortic homograft valve in 14 of 539 patients, giving a total incidence of 2.6%. It was an early postoperative complication in five patients (0.9%), and only one of these survived. Four hundred and six hospital survivors were followed for periods up to 76 mo. Nine of these patients (2.2%) developed infection of the homograft valve 11 to 66 mo postoperatively and four survived. Late endocarditis occurred more commonly in patients with a history of endocarditis prior to operation (P = 0.005). In only one of the nine patients with late endocarditis was the infection related to a peripheral leak around the graft. Most patients with late endocarditis rapidly developed severe homograft valve incompetence, which was the cause of death in four of the nine. Six patients were reoperated on and three of these survived.