Cardiac Valve Allografts 1962–1987

1. Front Matter

   Pages I-XVI

   PDF

2. Honorary guest lecture

   1. Evolution of the biological concept in cardiac surgery: A Pilgrim’s Progress

      • D. N. Ross

      Pages 1-11

3. Procurement and preservation techniques

   1. Allogeneic valve procurement in cardiac transplantation

      • Stephan Schüler, A. C. Yankah, R. Hetzer

      Pages 13-16

   2. Antibiotic sterilisation in the preparation of homovital homograft valves: Is it necessary?

      • Lorenzo Gonzalez-Lavin, L. McGrath, M. Alvarez, D. Graf

      Pages 17-21

   3. Procurement and viability of cardiac valve allografts

      • A. C. Yankah, R. Hetzer

      Pages 23-26

   4. Cryobiology of tissues

      • S. R. May, J. G. Baust

      Pages 27-34

   5. Cryopreservation of aortic valve homografts

      • J. K. Kirklin, J. W. Kirklin, A. D. Pacifico, S. J. Phillips

      Pages 35-36

   6. Factors affecting the viability of cryopreserved allograft heart valves

      • A. E. Heacox, R. T. McNally, K. G. M. Brockbank

      Pages 37-42

   7. Endothelial and fibroblast viability assays for tissue allografts

      • H. L. Bank, M. K. Schmehl, K. G. M. Brockbank

      Pages 43-48

   8. Discussion

      • D. Behrendt

      Pages 49-51

   9. Contribution for discussion: Problems of homograft procurement

      • A. L. Moulton

      Pages 52-54

   10. Contribution for discussion: Heart valve procurement in Berlin

       • F. Keller, A. C. Yankah, S. Schüler, R. Klän, G. Offermann, H. Warnecke et al.

       Pages 55-57

4. Transplantation immunology of heart valve allografts

   1. Basic principles of transplantation immunology

      • W. Müller-Ruchholtz

      Pages 59-64

   2. Cryopreserved and fresh valved aortic homograft conduits in a chronic sheep model: Haemodynamic, angiographic and histological comparisons

      • R. A. Jonas, G. Ziemer, L. Armiger, L. Britton, A. R. Castaneda

      Pages 65-68

   3. Homograft valve calcification: Evidence for an immunological influence

      • Lorenzo Gonzalez-Lavin, J. Bianchi, D. Graf, S. Amini, C. I. Gordon

      Pages 69-74

   4. Pathology of human explanted aortic valve homografts: A comparative morphological study with porcine aortic valve explants

      • Y. A. Goffin, L. M. Gerlis, W. M. Jones

      Pages 75-76

   5. Antigenicity and fate of cellular components of heart valve allografts

      • A. C. Yankah, H.-U. Wottge, W. Müller-Ruchholtz

      Pages 77-87

   6. Immunohistopathology of cardiac valve allograft explants

      • H. K. Müller-Hermelink, A. C. Yankah

      Pages 89-94

   7. Applications and limitations of histocompatibility in clinical cardiac valve allograft surgery

      • Magdi Yacoub

      Pages 95-102

   8. Discussion

      • W. MüLLer-Ruchholtz, M. H. Yacoub

      Pages 103-106

It was the genius of Gordon Murray in Toronto that introduced the use of allografts into cardiac surgery in the 1950s. Soon after this on opposite sides ofthe world, Sir Brian Barratt-Boyes in Auckland, New Zealand, and Mr. Donald Ross in London, undertook to use allografts for the replacement of diseased aortic valves. Since that time the global interest in allografts has been patchy, episodic, and without a con­ sensus. Nonetheless, for the last 20 years at least three groups in the world have steadfastly pursued the development of new and relevant information concerning the use of allograft valves in humans. These are the centres of Sir Brian Barratt­ Boyes, Mr. Donald Ross, and Mark O'Brien in Brisbane. More recently, talented investigators, including Drs. Yankah, Yacoub, and others, have been developing information concerning the immunological aspects of the use of allografts, as well as their clinical use. No doubt, at present, cardiac valve allografts of one sort or another are the devices of choice for conduits and have an important place in the surgery of aortic valve replacement. Even so, in the mind of this writer at least, the future usefulness of allografts for the replacement of diseased cardiac valves and conduits between a ventricle and the pulmonary artery, remains problematic, and depends upon improvements in other devices for this purpose and upon improve­ ments that may be made in preparing and using allografts.

• anatomy
• artery
• cardiac surgery
• development
• heart
• immunology
• surgery
• transplantation

• Clinic for Cardiothoracic and Vascular Surgery, German Heart Center Berlin, Berlin (West) 65, Germany

  A. Charles Yankah, Roland Hetzer

• Dept. of Cardiovascular Surgery, Stanford University, Stanford, USA

  D. Craig Miller

• National Heart Hospital, London, UK

  Donald Ross, Jane Somerville

• Harefield Hospital, National Heart and Brompton Hospital, London, UK

  Magdi H. Yacoub

Policies and ethics