Abstract
Objective: Although mechanical prosthetic heart valves are most commonly used for aortic valve replacement in patients with aortic regurgitation due to noninfectious inflammatory vascular disease, postoperative perivalvular leakage and/or detachment of the prosthetic valve occurs due to the fragility of the aortic annulus. Aortic root replacement with cryopreserved homografts is reported to be useful in such patients.Methods: Three patients having aortic regurgitation associated with severe long-standing noninfectious inflammatory vascular disease-2 patients with Takayasu’s arteritis and 1 patient with Behçet disease-had the aortic root replacement by a cryopreserved aortic homograft valve and conduit.Results: All surgery was successful and the postoperative course uneventful. Echocardiography showed neither aortic regurgitation nor graft detachment at 6–39 months after operation.Conclusions: Homograft valve and conduit replacement is appropriate in patients with aortic regurgitation associated with noninfectious inflammatory vascular disease, with mid-term results favorable.
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Knott-Craig CJ, Elkins RC, Stelzer PL, Randolph JD, McCue C, Wright PA, et al. Homograft replacement of the aortic valve and root as a functional unit. Ann Thorac Surg 1994; 57: 1501–6.
Matsuki O, Okita Y, Almeida RS, McGoldrick JP, Hooper TL, Robles A, et al. Two decades’ experience with aortic valve replacement with pulmonary autograft. J Thorac Cardiovasc Surg 1988; 95: 705–11.
Daly RC, Orszulak TA, Schaff HV, McGovern E, Wallace RB. Long-term results of aortic valve replacement with nonviable homografts. Circulation 1991; 84: 81–8.
Santini F, Dyke C, Edwards S, Stavri G, Feccia M, Khan H, et al. Pulmonary autograft versus homograft replacement of the aortic valve: a prospective randomized trial. J Thorac Cardiovasc Surg 1997; 113: 894–900.
Lund O, Chandrasekaran V, Grocott-Mason R, Elwidaa H, Mazhar R, Khaghani A, et al. Primary aortic valve replacement with allografts over 25 years: valverelated and procedure-related determinants of outcome. J Thorac Cardiovasc Surg 1999; 117: 77–91.
Donaldson RM, Ross DN. Homograft aortic root replacement for complicated pros thetic valve endocarditis. Circulation 1984; 70: 178–81.
Haydock D, Barratt-Poves BG, Macedo T, Kirklin JW, Black-stone E. Aortic valve replacement for active infectious endocarditis in 108 patients: a comparison of free hand allograft valves with mechanical prostheses and bioprostheses. J Thorac Cardiovasc Surg 1992; 103: 130–9.
Niwaya K, Knott-Craig CJ, Santangelo K, Lane MM, Chandrasekaran K, Elkins RC. Advantage of autograft and homograft valve replacement for complex aortic valve endocarditis. Ann Thorac Surg 1999; 67: 1603–8.
Tuna IC, Orszulak TA, Schaff HV, Danielson GK. Results of homograft aortic valve replacement for active endocarditis. Ann Thorac Surg 1990; 49: 619–24.
Aoyagi S, Kosuga K, Fukunaga S, Akashi H, Oryoji A, Oishi K. Valve detachment after aortic valve replacement: a successfully reoperated case with the Cabrol technique. Jpn Circ J 1996; 60: 377–81.
Eishi K, Nakajima S, Kitoh Y, Nakano K, Motomura N, Ohmori F, et al. Aortic root replacement with a cryopreserved aortic homograft In a patients with giant cell aortitis following two Bentall’s type operations. J Heart Valve Dis 1995; 4: 509–12.
Motomura N, Kawazoe K, Kito H, Eishi K, Kawashima Y, Oka T. Application of cryopreserved allograft to aortic root replacement for valve detachment due to aortitis. J Jpn Assn Thorac Surg 1993; 41: 1426–30.
Yamauchi M, Eishi K, Sasako K, Nakano K, Isobe F, Kosakai Y, et al. A case of aortitis operated twice Bentall’s operation due to valve (graft) detachment. Kyobu Geka 1994; 47: 1083–85.
Nakaya M, Kawazoe K, Ohara K, Kosakai Y, Sasagi K, Adachi M, et al. Long-term follow-up results on Bentall’s and our modified procedure. Kyobu Geka 1991; 44: 682–6.
O’Brien MF, McGiffin DC, Stafford EG. Allograft aortic valve implantation techniques for all types of aortic valves and root pathology. Ann Thorac Surg 1989; 48: 600–9.
Jaggers J, Fullerton DA, Campbell DN, Clark DR. LVOT pseudoaneurysm: a late complication of extended aortic root replacement. Ann Thorc Surg 1996; 62: 1198–9.
Smith JA, McKenzie TC, Davis BB. Dissection of allograft ascending aorta after aortic root replacement. Ann Thorc Surg 1996; 61: 1011–2.
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Sakuma, K., Akimoto, H., Yokoyama, H. et al. Cryopreserved aortic homograft replacement in 3 patients with noninfectious inflammatory vascular disease. Jpn J Thorac Caridovasc Surg 49, 652–655 (2001). https://doi.org/10.1007/BF02912473
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DOI: https://doi.org/10.1007/BF02912473