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Full-root Aortic Valve Replacement by Stentless Aortic Xenografts in Patients with Small Aortic Roots
Published on: May 21, 2017
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Root Replacement for Graft Infection Using an All-Biologic Xenopericardial Conduit
Sabina PW Guenther1, Angela Reichelt2, Sven Peterss3
1Department of Cardiac Surgery, University Hospital Munich, Ludwig-Maximilian-University, Munich, Germany. Electronic correspondence: sabina.guenther@med.uni-muenchen.de.
The Journal of Heart Valve Disease
|December 24, 2016
Summary
Aortic root replacement using a xenopericardial conduit is feasible for graft infections, offering an available alternative to homografts. While mortality is substantial, early reinfection rates are low, though long-term durability requires further study.
Area of Science:
- Cardiovascular Surgery
- Infectious Disease Management
- Biomaterials in Medicine
Background:
- Graft infection after aortic root replacement presents management challenges.
- The choice of graft material for aortic root replacement (ARR) is debated.
- This study evaluates xenopericardial conduits for redo-surgery in infected aortic roots.
Purpose of the Study:
- To assess the initial results of aortic root replacement (ARR) using a xenopericardial all-biologic conduit for infection.
- To compare this approach with homografts or prosthetic materials.
- To investigate the feasibility and early outcomes of this redo-surgery technique.
Main Methods:
- Retrospective analysis of 18 consecutive patients undergoing redo-surgery for aortic root infection.
- Use of xenopericardial all-biologic conduit (BioIntegral) for aortic root replacement.
- Inclusion of imaging (CT, PET-CT) and assessment of perioperative parameters and outcomes.
Main Results:
- The 30-day mortality was 22%, with myocardial failure and prior isolated AVR as risk factors.
- Early graft reinfection occurred in 6% of patients, resulting in 94% freedom from reinfection.
- No structural valve deterioration was observed during the mean 12-month follow-up.
Conclusions:
- Aortic root replacement with xenopericardial conduits is technically feasible for treating graft infections.
- The off-the-shelf availability of xenopericardial conduits is advantageous.
- While early outcomes are promising with low reinfection rates, long-term durability and infection eradication need further investigation.
