Isolated aortic valve replacement. A six-year follow-up.

A selected group of 259 patients who underwent aortic valve replacement was analyzed retrospectively for early and late mortality and late valve failures up to six years following operation. In this group, 100 patients received aortic valve homografts, 100 pulmonary valve autografts and 59 Starr-Edwards prosthetic valves. The two tissue valve groups, composed of younger, healthier individuals, had a lower early mortality rate than did the group receiving prostheses; mortality decreased even further with additional surgical experience. The homograft group also showed a lower long-term mortality and complication rate. The incidence and significance of the appearance of a diastolic murmur in the tissue valve group were also studied and seemed to play a major prognostic role for these patients.