“…112 Reinfection of synthetic prostheses or prosthetic materials, normally employed in cases of complex endocarditis when a homograft is not used, is even more daunting and technically demanding than in reinfection of an implanted homograft. 4,23,29,66,88,89 In this context, the safety and effectiveness of Ao-H over conventional prosthesis on the recurrence of infection has been widely reported in several observational studies, 4,23,29,43,101,113,114 albeit with a difference in resistance to infection found between the valve and aortic wall of Ao-H. 108 Between 2% and 5.3% of patients with relapse or recurrence of infection following aortic valve, endocarditis surgery occur within the first year. 16,29 Recent reports showed a low recurrence of endocarditis in homograft even in complex cases with extensive injury of heart structure.…”