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These results are retrospective and of a predominantly North Americanexperience but do constitute a large number over a long period of time.Several interesting points are raised. The mortality from replacement with a homograft washigher, but this is a newer and more complex procedure and may reflect alearning curve. This group would also not require anticoagulants and 2% of late mortality was from warfarin induced hemorrhage. Additional information An editorial accompanies this article (N Engldoi:10.1186/ccf-1999-265 fatcat:co43tk2lkfc5vktdi7hmpivuue