A new method of autologous fascia lata replacement for aortic valvular disease.

Based on Senning's (1967) technique of aortic valve reconstruction with fascia lata, and on our own experience with Edwards' (Edwards, Karp, Robillard, and Kerr, 1969) and Ionescu's methods of fashioning fascia lata valves (Ionescu, Ross, Deac, Grimshaw, Taylor, Whitaker, and Wooler, 1970) we have developed a new procedure for the construction of aortic fascia lata valves without prosthetic support. Such a valve has the advantage of imitating the normal anatomy and physiology of the aortic valve as closely as possible. With the valves fixed on rigid rings we have observed pressure gradients of up to 50 mmHg. Our method of valvular replacement was used even in a patient with active endocarditis, thus avoiding the introduction of foreign material. Two conditions are required for a correct aortic valvular replacement without prosthetic support: (1) the measurements of the new valve must correspond to those of the aortic annulus of the receiver. As there is no way of measuring these before opening the aorta, the technique has to be expeditious; (2) the technique of insertion of the valve must be simple. On the basis of these requirements we have developed a method that permits the rapid construction (15 minutes) and easy insertion of a 'tailored' aortic valve made of fascia lata.