Cryopreserved pulmonary homograft: postimplant changes.
A 20-year-old man who had undergone the Ross procedure (1994) for congenital aortic stenosis was admitted for replacement of his stenotic PH (2003). His native pulmonary valve had been replaced with a PH at that time and he had since undergone two balloon dilatations of the stenotic PH (1996 and 1998). He was asymptomatic, played basketball against medical advice, reported mild breathlessness on exertion and occasional palpitation. He had quit smoking recently after four-pack years. He had a blood pressure of 130/80 mm Hg, a regular pulse of 64 and clear lungs on auscultation. S1, S2 were normal and a 3/6 ejection systolic murmur was heard at the left sternal border. Electrocardiogram showed