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Apicoaortic valved conduit: potential for progress?

Ulf Lockowandt1

  • 1Department of Cardiothoracic Surgery and Anesthesiology, Karolinska University Hospital, Stockholm, Sweden. ulf.lockowand@karolinska.se

The Journal of Thoracic and Cardiovascular Surgery
|September 27, 2006
PubMed
Summary
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The apicoaortic valved conduit is a viable surgical option for high-risk patients needing aortic valve replacement, offering potential for future improvements in outcomes.

Area of Science:

  • Cardiovascular Surgery
  • Thoracic Surgery
  • Medical Devices

Background:

  • Increasing number of elderly patients require aortic valve replacement.
  • Complicating factors like prior coronary bypass grafting and ascending aorta atherosclerosis are common.
  • Apicoaortic valved conduit is an uncommon surgical option for aortic valve replacement.

Purpose of the Study:

  • To describe the techniques and outcomes of apicoaortic valved conduit insertions.
  • To evaluate the feasibility of this procedure in high-risk patients.

Main Methods:

  • Retrospective review of 13 high-risk patients undergoing apicoaortic valved conduit insertion from 2002-2005.
  • Patients had severe calcific aortic stenosis with complicating factors (porcelain aorta, prior CABG, or both).

Related Experiment Videos

  • Procedures utilized off-pump techniques or a heparinized miniextracorporeal circulation system.

    • Main Results:

    • Mean intensive care and hospital stays were 2 and 12 days, respectively.
    • 30-day mortality was 15% (2 patients), with later mortality at 23% (3 patients).
    • 8 surviving patients were in New York Heart Association class I or II at follow-up with low gradients over the conduit.

    Conclusions:

    • Apicoaortic valved conduit is a feasible option for high-risk patients undergoing aortic valve replacement.
    • The procedure demonstrates potential for technical development and improved outcomes.
    • Further research and refinement of techniques are warranted.