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Updated: May 22, 2026
12:17
Full-root Aortic Valve Replacement by Stentless Aortic Xenografts in Patients with Small Aortic Roots
Published on: May 21, 2017
Are thromboembolic and bleeding complications a drawback for composite aortic root replacement?
Mohammad A Zafar1, Emily A Farkas, Andrei Javier
1Section of Cardiac Surgery, Yale University School of Medicine, New Haven, Connecticut 06510, USA.
The Annals of Thoracic Surgery
|May 26, 2012
Summary
Composite aortic root replacement demonstrates excellent long-term survival with low rates of thromboembolism and bleeding complications. These findings provide crucial context for evaluating alternative valve-sparing procedures.
Area of Science:
- Cardiovascular Surgery
- Thoracic Surgery
- Aortic Surgery
Background:
- Valve-preserving aortic root reconstruction is increasingly common.
- Concerns exist regarding thromboembolism and bleeding after composite graft replacement.
- This study evaluates long-term complications of composite aortic root replacement.
Purpose of the Study:
- To assess the incidence of thromboembolism and bleeding after composite aortic root replacement.
- To compare outcomes with alternative valve-sparing techniques.
- To provide long-term follow-up data on composite graft aortic root replacement.
Main Methods:
- 306 patients underwent composite aortic root replacement between 1995 and 2011.
- Mechanical (n=242) or biologic (n=64) conduits were used.
- Long-term follow-up (mean 56 months) utilized an Aortic Database, patient interviews, and the Social Security Death Index.
Main Results:
- Hospital mortality was 2.9% overall, decreasing to 1.4% in the last 8 years.
- Freedom from bleeding, stroke, and distal embolism was 91.3%±2.4% at 10 years.
- Survival at 10 years was 80.9%±4.6%, comparable to the general population, with 99% freedom from reoperation.
Conclusions:
- Composite aortic root replacement offers excellent survival with minimal thromboembolic and bleeding complications.
- These results highlight the low morbidity associated with this procedure.
- Data supports a balanced consideration of composite grafts versus valve-preserving aortic root reconstruction.
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