Reoperation for massively calcified pulmonary valve heterografts. Surgical considerations

Calcifications of pulmonary valve heterografts inserted in children are more frequently recognized with increasing follow-up periods and may lead to reoperation. This complication is common with our non-industrially prepared procine valves and may also be observed with Hancock porcine heterografts. Reoperation is rendered difficult by incrustation of the massively calcified heterograft into the posterior aspect of the sternum and because of the need of adequate exposure of the pulmonary bifurcation. Four patients were successfully reoperated on by the authors. The valves were not replaced. An improved surgical technique used in the last three cases is described.