Autologous fascia lata transplantation for heart valve replacement. A two-year experience at the National Heart Hospital, London.

patients underwent 262 valve replacements with frame-mounted autologous fascia lata valves in the aortic, mitral, and/or tricuspid positions at the National Heart Hospital. A single fascia lata valve was inserted in 146 patients and multi-valve replacement was performed in 55 instances. Hospital and late mortality are comparable with that following other procedures of heart valve replacement. One hundred and fifty-four patients with 193 fascia lata valves were available for follow-up. A retrospective analysis of this method of valve replacement has been undertaken to assess the suitability of fascia lata as a heart valve substitute as well as the clinical results achieved by this method of valve replacement. developed a method of fabricating a three-leaflet fascia lata valve mounted on a Dacron-covered metal frame. The valve design permits its use in the aortic, mitral or tricuspid position. The major advantage of this valve was thought to be that it is made of an autologous tissue that should remain alive after implantation. This tissue is constantly available and the valves can be constructed in different sizes. Technical details of the fabrication and insertion of these valves have been described (Ionescu and Ross, 1969; Ionescu et al., 1970a, 1970c). Now that more than two years have elapsed since the introduction of this method, a retrospective analysis can be undertaken in regard to the valve design and the suitability of fascia lata, as well as to the clinical results achieved by this procedure of heart valve replacement. were devised and tested experimentally. They have been used in a limited number of patients near the end of the series and are not comparable with the large group of patients with frame-mounted fascial valves. This report will therefore be confined to patients with supported fascia lata valves. Two hundred and one patients underwent 262 valve replacements with a frame-mounted fascial valve in the aortic, mitral, and/or tricuspid position between April 1969 and December 1970 at the National Heart Hospital. Seventy-nine patients were females and 122 were males; the majority were in the fifth and sixth decades (Fig. 1). One hundred and eighteen patients (58%) had had rheumatic fever (76% of those patients having mitral valve involvement gave a positive history of rheumatic fever). Nineteen patients (9.4%) had a history of bacterial endocarditis. Fifty-nine of the replaced valves had undergone previous surgical attention (22-9%); in 29 of these valves a conservative procedure had been done and in …