Heart Valve Replacement with Aortic Heterografts: Follow-up Study

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Abstract

Between February, 1967, and March, 1969, 87 patients had heart valves replaced with aortic heterografts. Several types of supported grafts were used. In the 70 operative survivors there have been two groups of late complications: graft failure in 19 patients and other major complications not related to the graft per se in 7 patients.

There are 45 long-term survivors with aortic heterografts. Among these, 10 have a regurgitant murmur while 35 have obtained a good result.

The incidence of graft failure in this series has been 27.1% (19 patients), while graft dysfunction has occurred in 10 of the patients.

Microscopical examination of failed grafts showed cellular infiltration of the cusps, extensive changes in connective tissue and ground substance, and lack of endothelialization. These changes suggest that the transplanted aortic heterograft valve gradually becomes a mechanically vulnerable structure in a state of rejection.

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Supported in part with the aid of a grant from the British Heart Foundation.

We are indebted to Miss Beryl Walsh from the Department of Medical Photography for the illustrations.

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