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Long-term function of cryopreserved aortic homografts. A ten-year study
J K Kirklin1, D Smith, W Novick
1Department of Surgery, University of Alabama, Birmingham 35294-0007.
The Journal of Thoracic and Cardiovascular Surgery
|July 1, 1993
Summary
Cryopreserved aortic valve homografts show excellent long-term survival and function. Younger recipient age is a risk factor for leaflet failure, but most patients maintain good functional class.
Area of Science:
- Cardiovascular Surgery
- Cardiac Transplantation
- Valvular Heart Disease
Background:
- Cryopreserved aortic valve homografts are utilized for aortic valve replacement.
- Long-term functional data and echocardiographic assessments are limited for these homografts.
Purpose of the Study:
- To evaluate the long-term outcomes and valve function of cryopreserved aortic valve homografts.
- To identify risk factors associated with homograft failure.
Main Methods:
- A retrospective study of 178 patients who received cryopreserved aortic valve homografts between 1981 and 1991.
- Serial echocardiographic assessments were performed in 149 patients to evaluate valve function.
- Survival and freedom from explantation/leaflet failure were analyzed.
Main Results:
- Overall survival was 85% at 8 years; survival for isolated primary replacement was 94% at 8 years.
- Freedom from explantation for leaflet degeneration was 95% at 8 years.
- Freedom from leaflet failure was 85% at 8 years, with younger recipient age identified as a risk factor.
Conclusions:
- Cryopreserved aortic valve homografts demonstrate favorable long-term survival and durability.
- Most patients achieve good functional status (NYHA class I or II) long-term.
- Younger recipient age necessitates careful consideration due to increased risk of leaflet failure.