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What are the long-term outcomes and complication rates of homologous dura-mater allografts for cardiac valve replacement?
What are the long-term outcomes and complication rates of homologous dura-mater allografts for cardiac valve replacement?
Homologous dura-mater allografts showed satisfactory long-term results for mitral and tricuspid valve replacement but high rates of valve dysfunction and reoperation for aortic valve replacement.
Higher aortic dysfunction rates may warrant position-specific caution; leaves open allograft durability for randomized confirmation.
Homologous dura-mater valve was employed in a series of 2.338 patients in the period between January 1971 and January 1979. A restricted group of the first 272 patients were followed-up from six to eight years. This study showed gratifying results following mitral and tricuspid valves replacement and not as satisfactory results after aortic replacement. The postoperative complications were, for mitral valve: fungal endocarditis (0.68%), bacterial endocarditis (2.56%) thromboembolism (1.36%) valve dysfunction (12.9%) and reoperation was performed in 5.12% of the cases. For aortic valve replacement there was fungal endocarditis in 1.36% of cases, bacterial endocarditis in 5.68%, valve dysfunction in 29.54% and the incidence of reoperation was 23.28%. No anticoagulants were employed in this series.
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Stolf et al. (1980) studied this question.
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