Aortic valve replacement with homograft and autograft valves. Performance of 615 valves over 15 years.

Homograft valve replacement of the diseased aortic valve with a homologous aortic valve inserted in the sub-coronary position was first performed in July 1962 (Ross 1962). The procedure of transferring the patients autologous pulmonary valve to the aortic position has been used since 1967 (Ross 1967). The long term performance of homograft vaives has not been regarded as satis facrory in some centres (Copeland 1977, Anderson and Hancock 1977) whereas others have shown it to be an excellent valve replacement (Barratt-Boyes 1977; Bodnar et ai 1979). The differing experiences may be the results of alternative methods of steriliza tion, preservation and surgical insertion. This paper presents information on isolated aortic valve replacements with either homograft or autograft valves over a 15 year period. MÀTERIALS AND METHODS Six hundred and fifreen valves have been followed for up to 15 years, and there were 145 freeze dried homografts, 89 frozen homografts, 202 fresh homograks and 179 pulmonary autografts (Table 1). The details of the different steriiization and preserva tion methods and surgical techniques have been outlined (Ross et ai 1979; Bodnar et ai 1979). This paper presents information on valve performance gathered from patient records, from routine OutPatient Clinics, doctor's letters, re-operations and post-mortem reports.