Mid-term results of aortic root replacement using a self-assembled biological composite graft.

Meszaros, Katharina; Liniger, Sophia; Czerny, Martin; Stanger, Olaf; Reineke, David Christian; Englberger, Lars; Carrel, Thierry (2014). Mid-term results of aortic root replacement using a self-assembled biological composite graft. Interactive cardiovascular and thoracic surgery, 19(4), pp. 584-589. Oxford University Press 10.1093/icvts/ivu186

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OBJECTIVES To report the mid-term results of aortic root replacement using a self-assembled biological composite graft, consisting of a vascular tube graft and a stented tissue valve. METHODS Between January 2005 and December 2011, 201 consecutive patients [median age 66 (interquartile range, IQR, 55-77) years, 31 female patients (15.4%), median logistic EuroSCORE 10 (IQR 6.8-23.2)] underwent aortic root replacement using a stented tissue valve for the following indications: annulo-aortic ectasia or ascending aortic aneurysm with aortic valve disease in 162 (76.8%) patients, active infective endocarditis in 18 (9.0%) and acute aortic dissection Stanford type A in 21 (10.4%). All patients underwent clinical and echocardiographic follow-up. We analysed survival and valve-related events. RESULTS The overall in-hospital mortality rate was 4.5%. One- and 5-year cardiac-related mortality rates were 3 and 6%, and overall survival was 95 ± 1.5 and 75 ± 3.6%, respectively. The rate of freedom from structural valve failure was 99% and 97 ± 0.4% at the 1- and 5-year follow-up, respectively. The incidence rates of prosthetic valve endocarditis were 3 and 4%, respectively. During a median follow-up of 28 (IQR 14-51) months, only 2 (1%) patients required valve-related redo surgery due to prosthetic valvular endocarditis and none suffered from thromboembolic events. One percent of patients showed structural valve deterioration without any clinical symptoms; none of the patients suffered greater than mild aortic regurgitation. CONCLUSIONS Aortic root replacement using a self-assembled biological composite graft is an interesting option. Haemodynamic results are excellent, with freedom from structured valve failure. Need for reoperation is extremely low, but long-term results are necessary to prove the durability of this concept.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Cardiovascular Disorders (DHGE) > Clinic of Cardiovascular Surgery

UniBE Contributor:

Czerny, Martin; Stanger, Olaf; Reineke, David Christian; Englberger, Lars and Carrel, Thierry

Subjects:

600 Technology > 610 Medicine & health

ISSN:

1569-9293

Publisher:

Oxford University Press

Language:

English

Submitter:

Sara Baumberger

Date Deposited:

17 Feb 2015 11:35

Last Modified:

27 Oct 2015 11:27

Publisher DOI:

10.1093/icvts/ivu186

PubMed ID:

24994702

Uncontrolled Keywords:

Aortic root replacement, Biological valve, Echocardiography, Results

BORIS DOI:

10.7892/boris.63347

URI:

https://boris.unibe.ch/id/eprint/63347

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