The long-term performance of beta-propiolactone-treated homografts was clearly different between operative survivors of aortic valve replacement (n = 27) and those of right ventricular outflow tract reconstruction (n = 11). The reoperation-free survival rate at 20 years was 14.8 +/- 6.8 (standard error)% in the former and 77.8 +/- 13.9% in the latter. Even a nonviable aortic homograft can be favorably accepted as a material for right ventricular outflow tract reconstruction in contrast to the aortic position.