Homograft Aortic Valve Replacement: The Subcoronary and Cylindrical Techniques

Abstract

Aortic valve replacement using the homograft valve has an important place in the cardiac surgical armamentarium. Despite this, the homograft valve is still not widely used, in part due to the perceived difficulty of the procedure compared with aortic valve replacement using prosthetic devices , less convenient availability of the homograft compared with that of prosthetic devices, and concerns regarding homograft valve failure. This section outlines the subcoronary technique (and its variations) and cylindrical technique for aortic valve replacement using the homograft aortic valve. Homograft aortic valves had a short investigational' and clinical2 application by insertion in the descending thoracic aorta. However, it was Ross3 who first performed a homograft aortic valve replacement in the orthotopic position using a single suture line technique based on the work of Duran and Gunning4 In the same year, working independently, Barrett-Boyes5 also described the subcoronary technique using a double