Long-term function of aortic homografts as the right ventricular outflow tract

Physical examination, chest roentgenography, phonocardiography, and right heart catheterization were used to evaluate the function of composite aortic homografts inserted as right ventricular outflow tracts in 13 patients 1.8 to 7 years previously. All homografts in these patients who were followed for 2 or more years demonstrated calcification of the aortic wall, but valve leaflets were spared. Moderate pulmonary insufficiency was present in eight patients with single cusp partial homografts, but was well tolerated in all. Homograft valve insufficiency was mild in five patients with complete homografts. No patient had an outflow tract gradient greater than 32 mm Hg. The average gradient was 18.5 +/- 2.7 (SEM) mm Hg. Abnormality of pulmonary blood flow was found in three patients and could be related to previous Waterston or Potts anastomoses. No late morbidity due to homograft degeneration has occurred and the long-term function of these conduits appears to be good.