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Cryopreserved aortic viable homograft for active aortic endocarditis
Jean-Michel Grinda1, Jean-Luc Mainardi, Nicola D'Attellis
1Department of Cardiac Surgery, Hôpital Européen Georges Pompidou, Paris, France. jean-michel.grinda@egp.ap-hop-paris.fr
The Annals of Thoracic Surgery
|March 1, 2005
Summary
Cryopreserved aortic viable homografts (CAVH) effectively treat active aortic endocarditis, showing good short and long-term results. This method avoids prosthetic materials, offering a viable surgical option for patients with this severe infection.
Area of Science:
- Cardiovascular Surgery
- Infectious Diseases
- Transplantation
Background:
- Active aortic endocarditis presents significant challenges in valve replacement surgery.
- Destructive lesions necessitate effective treatment strategies to improve patient outcomes.
Purpose of the Study:
- To evaluate the short-term and long-term efficacy of cryopreserved aortic viable homograft (CAVH) in treating active aortic endocarditis.
- To assess the safety and durability of CAVH as an alternative to prosthetic materials.
Main Methods:
- A cohort of 104 patients with active aortic valve endocarditis underwent CAVH replacement between 1992 and 2002.
- Patients included those with native or prosthetic valve endocarditis, isolated or plurivalvular involvement.
- Intraoperative transesophageal echocardiography was systematically employed; bacteriologic diagnosis was obtained in 80% of cases.
Main Results:
- Hospital mortality was 5%. During a mean follow-up of 61 months, actuarial survival at 10 years was 83%, with 93% free from cardiac death.
- Freedom from reoperation at 10 years was 76%, and freedom from recurrent endocarditis was 93%.
- No thromboembolic complications were observed, highlighting the safety profile of CAVH.
Conclusions:
- Cryopreserved aortic viable homografts demonstrate effectiveness in managing the destructive nature of active aortic endocarditis.
- CAVH provides satisfactory immediate and long-term clinical outcomes, including low rates of reoperation and recurrent infection.
- The use of CAVH offers a valuable alternative to prosthetic materials, potentially enabling faster surgical treatment of active aortic endocarditis.