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[Aortic valve replacement with homografts. An overview]
H Nägele1, V Döring, W Rödiger
1Abteilung für Thorax- Herz- und Gefässchirurgie, Universitätskrankenhaus Hamburg-Eppendorf. naegele@UKE.uni-hamburg.de
Herz
|January 6, 2001
Summary
Human heart valve (homograft) replacement offers a near-natural solution in cardiac surgery, avoiding anticoagulation. Aortic homografts show excellent results, but availability limits their use.
Area of Science:
- Cardiovascular Surgery
- Transplantation Immunology
Background:
- Human heart valves (homografts) have been used in cardiac surgery for 30 years.
- Homografts offer an alternative to mechanical or xenobiotic prostheses, avoiding anticoagulation and restoring near-normal anatomy.
Purpose of the Study:
- To provide an overview of homograft harvesting, preparation, conservation, and clinical application.
- To discuss operative techniques, complications, and postoperative care, emphasizing immunologic aspects.
Main Methods:
- Literature review focusing on standard protocols from the European Homograft Bank.
- Analysis of homograft use in aortic valve disease, pediatric surgery, and specific procedures like the Ross operation.
Main Results:
- Aortic homografts demonstrate excellent long-term results for aortic valve replacement, particularly in specific patient groups.
- Pulmonic homografts show a significant rate of malfunction; mitral homograft results are disappointing.
- Availability limitations restrict homograft use to specialized indications.
Conclusions:
- Homografts are valuable for aortic valve replacement, especially in specific patient populations and pediatric cardiac surgery.
- Further research is needed to compare homografts with other options like the Ross operation or stentless xenografts.
- Addressing the mismatch between homograft availability and demand is crucial for expanding their application.