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Ann Thorac Surg 1989;48:365-370
© 1989 The Society of Thoracic Surgeons

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Articles

Viable Cryopreserved Aortic Homograft for Aortic Valve Endocarditis and Annular Abscesses

Department of Surgery, University of Texas Medical Branch at Galveston, Galveston, Texas

Accepted for publication April 11, 1989.

^* Address reprint requests to Dr Zwischenberger, Division of Cardiothoracic Surgery, Room 207, Clinical Sciences Building, UTMB, Galveston, TX 77550

Six consecutive patients with active aortic valve endocarditis, including 2 with extensive subannular aortic root abscess, were successfully treated with viable cryopreserved homograft aortic valve replacement. Two patients required extensive aortic root reconstruction with an appropriately trimmed aortic homograft to cover large abscess cavities. All patients showed resolution of infection with no perioperative mortality or clinically significant morbidity. Three patients had a minor degree of aortic insufficiency on postoperative echo-Doppler study. On follow-up at 6 to 48 months, all patients were in New York Heart Association functional class I. The resistance of the unstented homograft to infection makes it an attractive choice for patients requiring aortic valve replacement for active endocarditis. The results of surgical intervention in patients with extensive aortic root involvement may be further improved by the flexibility afforded by the homograft to be "custom-fit" to the abnormal aortic root and the ability to achieve secure valve fixation without use of prosthetic material.

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