AORTIC ALLOGRAFT IMPLANTATION TECHNIQUES - PATHOMORPHOLOGY AND REGURGITANT JET PATTERNS BY DOPPLER-ECHOCARDIOGRAPHIC STUDIES

Background. The diagnosis of allograft-specific pathology by echocardi ography has important consequences for patient counseling and research . This study describes the pathomorphologic findings and color Doppler jet patterns in a consecutive series of patients after allograft plac ement with either the subcoronary implantation or root replacement tec hnique. Methods. From 1987 to July 1996, the subcoronary allograft imp lantation technique and root replacement technique were used in 82 pat ients and 70 patients, respectively. These patients comprised the stud y group. Results. The incidence of paravalvular leaks and eccentric re gurgitant jets was higher with subcoronary implantation (41%) than wit h root replacement (11%). Patients with a subcoronary implanted allogr aft had a higher incidence of eccentric jets. Conclusions. These findi ngs support the concept of preservation of valve geometry after root r eplacement, as allograft-specific pathomorphologic abnormalities and e ccentric jets are more common after subcoronary implantation of allogr afts. Learning effects, however, cannot be excluded as the cause of th ese abnormalities. (C) 1998 by The Society of Thoracic Surgeons.