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Updated: Feb 14, 2026

Full-root Aortic Valve Replacement by Stentless Aortic Xenografts in Patients with Small Aortic Roots

Full-root Aortic Valve Replacement by Stentless Aortic Xenografts in Patients with Small Aortic Roots

Published on: May 21, 2017

[Aortic Root Replacement with Cryopreserved Allograft Aortic Valve].

Haruo Yamauchi¹, Minoru Ono

¹Department of Cardiac Surgery, The University of Tokyo, Tokyo, Japan.

Kyobu Geka. the Japanese Journal of Thoracic Surgery

|February 28, 2018

Summary

Aortic root replacement using cryopreserved allografts is effective for infectious endocarditis, especially with abscesses. Long-term use shows good survival but requires attention to potential pseudoaneurysms.

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Area of Science:

Cardiovascular Surgery
Infectious Diseases
Transplantation Immunology

Background:

Infectious endocarditis and prosthetic valve endocarditis pose significant challenges, often necessitating complex surgical interventions.
Cryopreserved allografts offer a potential solution, particularly in cases involving perivalvular abscesses, due to their inherent resistance to infection.

Purpose of the Study:

To evaluate the efficacy and long-term outcomes of aortic root replacement using cryopreserved allograft aortic valves in patients with active infectious endocarditis.
To assess survival rates, reoperation rates, and potential complications such as pseudoaneurysm.

Main Methods:

A retrospective analysis of 38 patients who underwent aortic root replacement with allograft aortic valves between December 1998 and March 2017 at the University of Tokyo.
Data collection included in-hospital mortality, long-term survival, freedom from reoperation, and incidence of pseudoaneurysm.

Main Results:

The in-hospital mortality rate was 18%, with a 5-year survival rate of 68% and a 5-year freedom from reoperation rate of 75%.
Clinical outcomes demonstrated improvement with increasing institutional experience.
Pseudoaneurysm was identified as a significant long-term complication requiring careful monitoring.

Conclusions:

Aortic root replacement with cryopreserved allografts is an effective treatment for active infectious endocarditis and prosthetic valve endocarditis, particularly when perivalvular abscesses are present.
While long-term outcomes are promising, vigilance for pseudoaneurysm development is crucial.
Despite improved clinical outcomes and insurance coverage, challenges remain in widespread adoption, including institutional certification, financial resources, and donor allograft availability.