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Full-root Aortic Valve Replacement by Stentless Aortic Xenografts in Patients with Small Aortic Roots
Published on: May 21, 2017
Stentless biological valved conduit for aortic root replacement: initial experience with the Shelhigh BioConduit
Abdullah Kaya1, Robin H Heijmen, J C Kelder
1Department of Cardiothoracic Surgery, St Antonius Hospital, Nieuwegein, The Netherlands. a_kaya33@hotmail.com
The Journal of Thoracic and Cardiovascular Surgery
|September 14, 2010
Summary
Midterm outcomes of the Shelhigh biological valved conduit (NR-2000C) show concerning results, particularly a high incidence of bioconduit endocarditis, prompting a search for alternative aortic root replacement options.
Area of Science:
- Cardiovascular Surgery
- Biomaterials Science
- Medical Device Evaluation
Background:
- Aortic root replacement is a critical procedure for various aortic pathologies.
- Biological valved conduits offer an alternative to mechanical prostheses but have their own set of complications.
- The Shelhigh biological conduit (NR-2000C) has been used for aortic root replacement, necessitating an evaluation of its long-term performance.
Purpose of the Study:
- To retrospectively evaluate the clinical outcomes and complications associated with the Shelhigh biological conduit model NR-2000C.
- To assess the midterm efficacy and safety of this specific biological valved conduit in patients undergoing aortic root replacement.
- To identify the incidence of major adverse events, including endocarditis and reoperation rates.
Main Methods:
- Retrospective analysis of 175 patients who underwent aortic root replacement using the Shelhigh biological conduit (NR-2000C) between November 1998 and December 2007.
- Patient data included indications for surgery (aneurysmal disease, endocarditis, dissection), demographics, perioperative mortality, and long-term follow-up.
- Outcomes assessed included overall and late mortality, survival rates, reoperation rates, and specific complications like endocarditis.
Main Results:
- Overall hospital mortality was 13.7%, with cardiac failure being the most common cause.
- Mean follow-up was 3.1 years, with 33.1% late deaths.
- Survival rates at 1 and 5 years were 77.6% and 54.6%, respectively.
- A significant complication was bioconduit endocarditis in 7.3% of patients, leading to reoperation in 5 cases.
Conclusions:
- The midterm results of the Shelhigh biological valved conduit (NR-2000C) are concerning due to a high incidence of endocarditis.
- The observed complication rates suggest potential limitations of this specific biological conduit for aortic root replacement.
- Further investigation into alternative prosthetic materials or devices is warranted given these findings.
