Clinical Experience with the Use of Aortic Valve Homografts for Reconstruction of the Pulmonary Artery, Pulmonary Valve, and Outflow Portion of the Right Ventricle

Abstract

Four patients with ventricular septal defect, infundibular right ventricular obstruction, and associated abnormalities of the pulmonary valve or main pulmonary artery have been treated by a combination of ventricular septal defect closure, infundibular myomectomy, and insertion of an aortic homograft into the pulmonary circulation. Pulmonary valvular competence has been restored in all four cases. A single fatality has resulted, and was associated with bacterial destruction of the homograft. The hemodynamics of pulmonary valvular insufficiency are discussed, and indications for homograft replacement of the pulmonary valve are outlined.