Skip to main content
Thorax logoLink to Thorax
. 1968 May;23(3):249–255. doi: 10.1136/thx.23.3.249

Long-term degenerative changes in aortic segment homografts, with particular reference to calcification

Brock 1
PMCID: PMC471786  PMID: 5656759

Abstract

The object of this article is to present observations derived from a long-term follow-up (over a period of 8-17 years) of a personal series of aortic segment homografts from which certain important information arises. It will be shown that in those grafts prepared and preserved in a `fresh' state, calcification has not occurred or has been trivial, whereas in 20 cases in which the graft has been prepared by freeze-drying, calcification is absent in only four, i.e., 21%. Nineteen of these 20 have been traced up to date; only one is so far missing. In spite of calcification the functional result has remained excellent; in all, the graft was used to replace a segment of aorta resected for aneurysm or for coarctation. The high incidence of aortic wall calcification must assume clinical significance in relation to aortic valve homografting. This procedure is now well established and it is important to consider the future of the valve homograft, especially as most grafts are being prepared by freeze-drying. By analogy from observations on the rate of homografting of aortic segments, calcification is likely to occur at least in that portion of the aortic wall which carries the valve cusps. Impairment of function of the cusps or their involvement in the calcific process seems likely.

Full text

PDF
249

Images in this article

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. 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]
  2. BROCK R. C. Aortic homografting; a report of six successful cases. Guys Hosp Rep. 1953;102(3):204–228. [PubMed] [Google Scholar]
  3. BROCK R. C., GRAHAM J. P. Resection of combined aneurysm and coarctation of the aorta with insertion of a homograft. Guys Hosp Rep. 1952;101(3):207–215. [PubMed] [Google Scholar]
  4. CREECH O., Jr, DE BAKEY M. E., COOLEY D. A., HALPERT B. Structural alterations in human aortic homografts one to two and one-half years after transplantation. Surg Gynecol Obstet. 1956 Aug;103(2):147–154. [PubMed] [Google Scholar]
  5. CREECH O., Jr, DEBAKEY M. E., SELF M., HALPERT B. The fate of heterologous arterial grafts: an experimental study. Surgery. 1954 Sep;36(3):431–444. [PubMed] [Google Scholar]
  6. DURAN C. G., MANLEY G., GUNNING A. J. THE BEHAVIOUR OF HOMOTRANSPLANTED AORTIC VALVES IN THE DOG. Br J Surg. 1965 Jul;52:549–552. doi: 10.1002/bjs.1800520716. [DOI] [PubMed] [Google Scholar]
  7. FOSTER J. H., COLLINS H. A., JACOBS J. K., SCOTT H. W., Jr LONG TERM FOLLOW-UP OF HOMOGRAFTS USED IN THE TREATMENT OF COARCTION OF THE AORTA. J Cardiovasc Surg (Torino) 1965 Mar-Apr;6:111–120. [PubMed] [Google Scholar]
  8. 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]
  9. Mohri H., Reichenbach D. D., Barnes R. W., Merendino K. A. A biologic study of the homologous aortic valve in dogs. J Thorac Cardiovasc Surg. 1967 Nov;54(5):622–628. [PubMed] [Google Scholar]
  10. POLLOCK A. V., PRATT D., SMIDDY F. G. Aortic homograft replacement: a sequel. Ann Surg. 1961 Mar;153:472–476. doi: 10.1097/00000658-196103000-00021. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. ROSS D. N. Homograft replacement of the aortic valve. Lancet. 1962 Sep 8;2(7254):487–487. doi: 10.1016/s0140-6736(62)90345-8. [DOI] [PubMed] [Google Scholar]
  12. SAUVAGE L. R., WESOLOWSKI S. A. The healing and fate of arterial grafts. Surgery. 1955 Dec;38(6):1090–1131. [PubMed] [Google Scholar]
  13. SHUCKSMITH H. S., MITCHELL W. M., ZINNEMANN K. Two and a half years' survival of a grafted abdominal aortic aneurysm with histological studies. Br J Surg. 1958 Sep;46(196):141–146. doi: 10.1002/bjs.18004619612. [DOI] [PubMed] [Google Scholar]
  14. Smith J. C. The pathology of human aortic valve homografts. Thorax. 1967 Mar;22(2):114–138. doi: 10.1136/thx.22.2.114. [DOI] [PMC free article] [PubMed] [Google Scholar]

Articles from Thorax are provided here courtesy of BMJ Publishing Group

RESOURCES