Aortic valve replacement with frame - mounted autologous fascia

Between June 1969 and August I970, 8o patients, aged 22 to 63 years, had lone aortic valve replacement with frame-mounted autologous fascia lata. The operative mortality was 3.8 per cent. Seventy-seven survivors have been followed for 3 to 4 years and 50 have had postoperative investigation. There have been 8 subsequent deaths, 3 from infective endocarditis, 4 from aortic regurgitation, and one unknown. Fifteen patients developed late aortic regurgitation. Seven required reoperation and valve tissue was found to have torn from the supporting frame in 6 patients. Serial investigations and clinical examination showed no evidence ofprogressive obstruction occurring in the valves. Late systemic emboli occurred in 9 patients. In view of the development of serious aortic regurgitation in survivors after 2 years and the occurrence of systemic emboli, this form of aortic valve replacement cannot be considered to be satisfactory in the long term, in comparison with other forms of biological or mechanical valve replacement.