ROOT REPLACEMENT FOR ALL ALLOGRAFT AORTIC VALVES - PREFERRED TECHNIQUE OR TOO RADICAL

From November 1985 to January 1994, 146 patients have received a viabl e cryopreserved allograft for aortic root replacement. The follow-up w as complete, with all events included to March 1st, 1994. The median a ge of patients was 49 years; 83.6% were male. Valve dysfunction (91 pa tients), primary aortic wall disease (45 patients), and a combination of both (10 patients) were the indications for aortic root replacement . The current operative mortality is 1.7% (three deaths in 172 patient s to July 1st, 1994). Four late deaths have occurred, with an 8-year a ctuarial survival of 85% +/- 8% (95% confidence limits). Endocarditis (two events) and thromboembolism (four events) had a low incidence. St ructural deterioration (three events) and reoperation for all causes ( nine events) have constituted low morbidity and are compared with the results after nonroot allograft implantation techniques. The clinical and echocardiographic evidence indicates that the immediate results of valve function with roof replacement are superior. But no statistical difference between aortic root replacement and nonroot procedures is apparent at 8 years, indicating that a longer follow-up is required be fore the answer to the question ''preferred technique or too radical'' can be answered.