The pathological changes in 34 homograft valves transplanted to the subcoronary position are described. The valves had been in place up to 30 months and did not show evidence of graft rejection. There was evidence of repopulation of the graft by host cells and endothelialization of the leaflet in one case. There were ten instances of homograft valve failure with valve cusp rupture in eight. In four patients who died 7 to 17 months after implantation, unusual organisms were demonstrable in the thickened calcified valve, although no organisms could be isolated during life. An unidentified fungus was present in two cases and possible mycoplasma in two other cases. The demonstration of homograft infection with unusual organisms suggests that special attention needs to be placed on attempted isolation of organisms in patients with homografts. The relationship of the method of sterilization and storage of homografts used in this series to these infections is unclear.
- © 1969 American Heart Association, Inc.