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Updated: May 27, 2026
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Standardized Technique of Aortic Valve Re-implantation for Valve-sparing Aortic Root Replacement
Published on: December 11, 2017
Outcome after homograft redo operation in aortic position
Anke Kowert1, Ferdinand Vogt, Andres Beiras-Fernandez
1Department of Cardiac Surgery, Ludwig-Maximilians-University, University Hospital Grosshadern, Munich, Germany. Anke.Kowert@med.uni-muenchen.de
Summary
Redo aortic valve replacement with homografts is feasible, with acceptable risks compared to other prostheses. However, homograft infection significantly increases mortality, and trans-apical procedures show promise for future use.
Area of Science:
- Cardiovascular Surgery
- Thoracic Surgery
- Medical Devices
Background:
- Homografts have been used for aortic valve replacement since 1992.
- Root replacement is the preferred technique, posing challenges for redo procedures.
- This study evaluates outcomes of redo homograft surgery using prospective data.
Purpose of the Study:
- To assess the outcomes of redo aortic valve replacement using homografts.
- To analyze data from the largest German patient cohort for this specific procedure.
- To compare the risks and survival rates of redo homograft surgery.
Main Methods:
- Analysis of 90 adult patients undergoing redo homograft aortic valve replacement between 1992 and 2009.
- Patients had homograft explantation due to infection or degeneration (stenosis/regurgitation).
- Procedures included valve-in-homograft, total homograft replacement, and trans-apical trans-catheter valve replacement.
Main Results:
- Mean time to redo surgery was 8.4 years; 73 males and 17 females (mean age 62.0 years).
- 30-day mortality was 8.9%, notably higher in patients with homograft infection.
- 1- and 5-year survival rates were 86.0% and 77.4%, respectively.
Conclusions:
- Redo homograft surgery carries an acceptable risk profile compared to other prostheses.
- Homograft infection is a significant risk factor for elevated mortality.
- Trans-apical procedures are safe and feasible, with potential for future application, excluding cases of valve infection.
