Melina G, De Robertis F, Gaer JA, et al. - Patients undergoing xenograft vs homograft full root aortic valve replacement (AVR) were investigated for the first time for their very long-term survival in this work. In a single institution, randomization of 166 patients (Mean age: 65±8 years) requiring aortic valve surgery to undergo Freestyle bioprosthesis (N = 90) or Homograft (N = 76) full root AVR was done between 1997 and 2005. For the Freestyle group vs the Homograft group, 20-year survival was 28.3±5% vs 25.1±5.7% respectively, which was comparable to the age/gender-matched UK general population. Comparable outcomes regarding the freedom from aortic valve reoperation at 20 years were evident for the Freestyle patients vs the Homograft recipients (67.9±8.8% vs 67.2±10.3%, respectively).