[Implants with aortic valve homografts in patients with critical left aortic stenosis]

This case study presents two patients with aortic stenosis and infective endocarditis (IE) who underwent homograft aortic valve replacement. The first patient is a 67 year old practicing surgeon. Twenty one years ago, he was admitted to our department for critical aortic stenosis, infective endocarditis (IE) and heart failure. He underwent homograft aortic valve replacement. After the surgery his condition improved dramatically and he returned to his practice. Current echocardiographic study shows normal function of the left ventricle and normal gradient across homograft aortic valve. The next case, a 33-year old happy mother of 5 children, is particularly interesting. When she was 15 years old, she was referred to surgery, diagnosed with bicuspid aortic valve stenosis, subaortic muscular stenosis and aneurysm of aortic sinus of Valsalva. She underwent homograft aortic valve and root replacement and excision of the sub-aortic muscle bulge. Eleven months later, she required another operation due to active IE. The St. Jude Medical aortic valve was implanted. Two months after the surgery a dysfunction of the implanted artificial valve was diagnosed. She again underwent the homograft aortic valve and root replacement with good long-term results. In the period spanning 1987-1997, she managed to deliver five babies without any complications whatsoever. Seventeen years later, the homograft aortic valve is still functioning fairly well. The homograft aortic valve replacement may be regarded as a viable option for patients with aortic stenosis and IE and for young women suffering from aortic valve disease who intend to be prospective mothers.