[Homograft implantation in heart surgery]

In order to fulfill in the field of cardiothoracic surgery the obligations of patient-care and research in a university facility according to the international standard it is nowadays absolutely necessary to run a homograft bank. Implantation of an allograft is a preferable choice for a number of different operations, i.e. in aortic valve endocarditis, complex congenital heart disease, Ross' operation and others. Furthermore, in children, women of childbearing age and patients in whom anticoagulation is contraindicated, heart valve replacement with allografts has become routine. The most important advantages of allografts are the excellent hemodynamic qualities and the low risk endocarditis. Anticoagulation is not necessary, because there is no risk for thromboembolism or hemolysis. For the patients mentioned above, these factors are decisive for their quality of life and their prognosis. Because of the shortage of donor organs and the priority of heart transplantation over allograft harvesting, the use of allografts should be limited to the above mentioned indications, mechanical and bioprothetic valves and, just lately available, bioprothetic valves from autogenous pericardium are appropriate.