LONG-TERM FUNCTION OF CRYOPRESERVED AORTIC HOMOGRAFTS - A 10-YEAR STUDY

Cryopreserved aortic valve homografts have become an accepted aortic v alve substitute, but long-term studies with echocardiographic assessme nt of valve function are largely unavailable. Between 1981 and January 1, 1991, a total of 178 patients aged 9 months. to 80 years (median 4 6 years) underwent implantation of a cryopreserved aortic valve homogr aft. Serial two-dimensional Doppler echocardiographic studies were obt ained in 149 patients. Overall survival was 91% at 1 year and 85% at 8 years. Survival of patients undergoing isolated primary infracoronary aortic valve replacement was 99% at 1 month and 94% at 8 years. Twelv e patients underwent homograft explantation. Freedom from explantation for leaflet degeneration was 95% at 8 years. Freedom from presumed le aflet failure (valve degeneration at explantation or aortic insufficie ncy grade 3/4 or more without reoperation on echocardiography) was 94% at 5 years and 85% at 8 years. By multivariable analysis younger reci pient age was the only risk factor identified for leaflet failure. Nin ety-five percent of patients followed up for 4 or more years were in N ew York Heart Association class I or II.