Abstract
Twenty-three patients have had calf or pig heterograft aortic valve replacements. Eight of these patients have required Starr-Edwards mitral ball-valve prostheses for associated mitral valve disease. There have been two hospital deaths and one late death. The 20 surviving patients have shown symptomatic improvement. Clinical evidence of incompetence is present in one patient. Pre-operative and post-operative ciné-aortograms show valve mobility with a wide central orifice. Heterografts have the advantages of homografts in being free from thromboembolism and from the need for anticoagulants; they exhibit some resistance to infection as compared with prosthetic valves. We think that heterografts, because of their wider range of size, can offer a better haemodynamic result with little clinical aortic incompetence. The long-term fate of aortic valve heterografts is not known with certainty, although the durability of homografts is better known. There is a possibility of late degeneration or rupture. If the valve continues to function normally, then it would be justifiable to recommend operation at an earlier stage in the progression of the patient's disease. At present, despite encouraging early results, we think the use of heterografts should be limited, like that of other prostheses, to those patients who show severe cardiac disability.
Full text
PDF
Images in this article
Selected References
These references are in PubMed. This may not be the complete list of references from this article.
- BARRATT-BOYES B. G. HOMOGRAFT AORTIC VALVE REPLACEMENT IN AORTIC INCOMPETENCE AND STENOSIS. Thorax. 1964 Mar;19:131–150. doi: 10.1136/thx.19.2.131. [DOI] [PMC free article] [PubMed] [Google Scholar]
- BIGELOW W. G., YAO J. K., ALDRIDGE H. E., HEIMBECKER R. O., MURRAY G. D. CLINICAL HOMOGRAFT VALVE TRANSPLANTATION. J Thorac Cardiovasc Surg. 1964 Sep;48:333–345. [PubMed] [Google Scholar]
- Barratt-Boyes B. G., Lowe J. B., Cole D. S., Kelly D. T. Homograft valve replacement for aortic valve disease. Thorax. 1965 Nov;20(6):495–504. [PMC free article] [PubMed] [Google Scholar]
- Binet J. P., Duran C. G., Carpenter A., Langlois J. Heterologous aortic valve transplantation. Lancet. 1965 Dec 18;2(7425):1275–1275. doi: 10.1016/s0140-6736(65)92287-7. [DOI] [PubMed] [Google Scholar]
- HOVIG T. AGGREGATION OF RABBIT BLOOD PLATELETS PRODUCED IN VITRO BY SALINE "EXTRACT" OF TENDONS. Thromb Diath Haemorrh. 1963 Jul 15;143:248–263. [PubMed] [Google Scholar]
- KERWIN A. J., LENKEI S. C., WILSON D. R. Aortic-valve homograft in the treatment of aortic insufficiency. Report of nine cases, with one followed for six years. N Engl J Med. 1962 Apr 26;266:852–857. doi: 10.1056/NEJM196204262661702. [DOI] [PubMed] [Google Scholar]
- MURRAY G. Homologous aortic-valve-segment transplants as surgical treatment for aortic and mitral insufficiency. Angiology. 1956 Oct;7(5):466–471. doi: 10.1177/000331975600700509. [DOI] [PubMed] [Google Scholar]
- O'Brien M. F., Clarebrough J. K. Preliminary communication heterograft aortic valve transplantation for human valve disease. Med J Aust. 1966 Jul 30;2(5):228–230. [PubMed] [Google Scholar]
- O'Brien M. F. Heterograft aortic valves for human use. Valve bank, techniques of measurement, and implantation. J Thorac Cardiovasc Surg. 1967 Mar;53(3):392–397. [PubMed] [Google Scholar]
- Paneth M., O'Brien M. F. Transplantation of human homograft aortic valve. Thorax. 1966 Mar;21(2):115–117. doi: 10.1136/thx.21.2.115. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Ross D. N. Aortic valve surgery. Ann R Coll Surg Engl. 1966 Sep;39(3):192–197. [PMC free article] [PubMed] [Google Scholar]
- SPAET T. H., ZUCKER M. B. MECHANISM OF PLATELET PLUG FORMATION AND ROLE OF ADENOSINE DIPHOSPHATE. Am J Physiol. 1964 Jun;206:1267–1274. doi: 10.1152/ajplegacy.1964.206.6.1267. [DOI] [PubMed] [Google Scholar]