Long-term performance of homograft and autograft valves.

Five hundred and eighty homograft valves have been inserted into the aortic position as isolated valve replacements, and followed up for 7--14 years. After ten years 90% of frozen homografts, 80% of autografts and 70% of freeze-dried homografts were free of valve-related death. There was only one embolism reported giving an incidence of one embolism per 143,928 patient months. Degeneration occurred in 14% of the autografts, in 30% of the freeze dried and in 60% of the frozen homografts after ten years. Eighty per cent of the fresh homografts have been free of degeneration after seven years, and 54% of freeze-dried valves have been free of degeneration after 14 years. Long-term performance of homograft and autograft valves in the aortic positon is comparable to that of any prosthetic or bioprosthetic valve. In addition, they are non-thrombogenic and excellent in terms of patient survival.