Aortic valve reconstruction with autologous fascia lata was performed in 33 patients (mean age 35 years) in 1966 and 1967. Eighty-two per cent had cusp extension rather than replacement, while 33% required additional intracardiac procedures. There were seven hospital deaths (21%) and 11 late deaths (33%), a total mortality of 54% over four years. Six late deaths followed reoperation for recurrent incompetence, and two other patients survived reoperation. Endocarditis (rickettsial, fungal, and bacterial) occurred in five cases, all required reoperation for incompetence, and four died. Sixty-nine per cent of the survivors of operation left hospital with competent valves and did better than the 31% with leaking valves in terms of late deaths, endocarditis, and reoperation for incompetence. Of the 15 patients (45%) still alive, 13 still have their original fascial valve, and of these only two (or perhaps three) have no diastolic murmur. Seven have insignificant murmurs and three have aortic incompetence. These poor results, particularly in the long term, make us sceptical about current enthusiasm for fascia lata heart valves.
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