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Extra resources for Cardiac Reconstructions with Allograft Tissues
Valves from patients with known connective tissue disease were excluded. The valve was excised with a portion of the ascending aorta and the anterior leaﬂet of the mitral valve. The valve was trimmed and rinsed, and the diameter of the valve measured with a calibrated obturator. The ﬁrst 92 valves used in this series were sterilized in betapropiolactone solution and incubated at 37°C for three hours. The valves was then washed in saline and stored in 250 ml Hank’s Solution containing penicillin, streptomycin, and tetracycline at 4 degrees centigrade.
J Thorac Cardiovasc Surg 1976;72:150–156. 25. Barratt-Boyes BG. Cardiothoracic surgery in the antipodes. J Thor Cardiovasc Surg 1979;78: 804–822. 26. The use of “fresh”unstented homograft valves for replacement of the aortic valve. J Thorac Cardiovasc Surg 1980;79:896–903. 27. Selzer A. Changing aspects of the natural history of valvular aortic stenosis. N Engl J Med 1987;317:91–98. 28. Penta A, Qureshi S, Radley-Smith R, Yacoub MH. Patient status 10 or more years after ‘fresh’ homograft replacement of the aortic valve.
2 Annular dimensions greater than 28 mm in diameter and/or a root dimension 3 mm larger than any easily available allograft may preclude allograft implantation or else require a preliminary annular reduction technique. The obturator measurement of the aortic root at the time of surgery should therefore be regarded as only a conﬁrmatory procedure; the allograft will have already been chosen, thawed and ready for implantation when the annulus size is ﬁnally checked. To optimize root implantation, careful planning is required to obtain, preoperatively, information about sizing and correct choice of the appropriate allograft available; with this strategy, it is possible to achieve a predictable result in the majority of presentations.