Over an eight-month period beginning in November 1969, 53 patients received 63 fascia lata heart valves at the Toronto General Hospital. The late results of this form of valve substitution are reviewed. The fascia used to fashion the tricuspid valve underwent progressive thickening and contracture and this process caused failure of the prosthesis within months of insertion. The mitral fascial prosthesis failed in a similar manner although the process took longer. The aortic fascia lata valve, however, has not shown progressive thickening after 3½ years and it has so far retained its functional integrity. Indeed, we have been impressed by the excellent clinical results and absence of complications such as thromboembolism although anticoagulation has not been used. We therefore consider that fascia lata valves offer a suitable alternative to other forms of aortic valve substitution, but are unsatisfactory for tricuspid or mitral valve replacement.
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