Multiple valve replacement with the fresh aortic homograft

Summary Clinical and laboratory experience with fresh aortic homografts would indicate that they are the best available substitute for damaged intracardiac valves. This experience led to their use for multiple valve replacement in 6 human beings. The aortic replacement is sutured directly into the recipient annulus whereas the mitral and tricuspid valve homograft must first be secured to a specifically designed support ring. There were no deaths in the series and all patients show marked improvement. All patients have discontinued anticoagulants after 2 to 3 months and there are no episodes of thromboembolism. As with most clinical homograft valve series, there is a significant incidence of mild aortic insufficiency. It is postulated that this phenomenon, unlike the experimental series, is primarily a mechanical problem relating to homograft size and recipient aortic root configuration. If valve supply is adequate, sterility is guaranteed, and the proper cusp orientation and support assured, the ideal valve replacement is available in the fresh aortic homograft.