Long-term outcomes following Medtronic Open Pivot valved conduit

Area of Science:

• Cardiovascular Surgery
• Biomaterials in Medical Devices
• Aortic Valve Disease

Background:

• Aortic root replacement is a complex surgical procedure.
• Modifications to the Bentall procedure have improved reproducibility.
• Long-term outcomes of the Medtronic Open Pivot valved conduit require further investigation.

Purpose of the Study:

• To evaluate the long-term outcomes of aortic root replacement using the Medtronic Open Pivot valved conduit.
• To identify predictors of mortality and morbidity in patients undergoing this procedure.

Main Methods:

• A prospective study of 246 patients undergoing aortic root replacement between 1999 and 2010.
• Utilized the Medtronic Open Pivot valved conduit.
• Follow-up included echocardiography and clinical assessment; survival analyzed using Cox proportional models, and morbidity using logistic regression.

Main Results:

• Overall mortality was 12% with 10-year survival of 79%.
• Predictors of mortality included preoperative myocardial infarction, urgent surgery, and decreased ejection fraction.
• Valve-related morbidity occurred in 11 patients; predictors included urgent surgery, aortic dissection, calcific aortic stenosis, and Marfan syndrome.

Conclusions:

• The Medtronic Open Pivot valved conduit is a safe and durable option for aortic root replacement.
• The procedure is associated with low morbidity and favorable 10-year survival rates.
• Further studies are needed to clarify the influence of valve gradients on survival.