Replacement of the aortic valve with cryopreserved aortic allograft: the procedure of choice for young patients.

The results of replacement of the aortic valve with cryopreserved aortic allograft are reviewed. There were no operative deaths in 88 patients. Thromboembolism did not occur in any patient and no anticoagulant medications were used. Actuarial freedom from reoperation for any reason was 89%; for structural deterioration it was 93% at 7.5 years. Infection was cured in all patients with endocarditis. Aortic allografts may be inserted by: (1) 120 degrees rotation freehand technique; (2) intact noncoronary sinus freehand technique; (3) aortic root enlargement technique; and (4) aortic root replacement technique. Zero thromboembolism without anticoagulants, high rate of cure of endocarditis, and the versatility of the tissue with a variety of methods for insertion to rebuild and remodel the aortic root to provide normal hemodynamic characteristics make aortic allograft the device of choice for replacement of the aortic valve in young patients.