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Two Decades Using Stentless Porcine Aortic Root in Right Ventricular Outflow Tract Reconstruction.

Michael W Kasten1, Jeremy L Herrmann2, Morgan Cox3

  • 1Division of Thoracic and Cardiovascular Surgery, Indiana University School of Medicine, Indianapolis, Indiana.

The Annals of Thoracic Surgery
|September 18, 2020
PubMed
Summary
This summary is machine-generated.

The stentless porcine aortic root prosthesis (SPAR) shows excellent durability and low reintervention rates for right ventricular outflow tract reconstruction. This study confirms its effectiveness in pulmonary position with favorable long-term outcomes.

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Area of Science:

  • Cardiovascular Surgery
  • Medical Devices
  • Prosthetic Valves

Background:

  • The stentless porcine aortic root prosthesis (SPAR) is a recognized option for right ventricular outflow tract reconstruction (RVOTR).
  • Indiana University Methodist Hospital has utilized SPAR for RVOTR since 1998.
  • This study evaluates the medium- to long-term performance of SPAR in the pulmonary position.

Purpose of the Study:

  • To assess the midterm and long-term outcomes of stentless porcine aortic root prosthesis (SPAR) used for right ventricular outflow tract reconstruction (RVOTR).
  • To evaluate survival, freedom from reintervention, and incidence of endocarditis and conduit dysfunction associated with SPAR in the pulmonary position.

Main Methods:

  • Retrospective chart review of patients aged over 18 who underwent RVOTR with SPAR between April 2000 and October 2019.
  • Primary outcomes: overall survival and freedom from valvular reintervention.
  • Secondary outcomes: endocarditis and conduit dysfunction via echocardiography or cardiac MRI.

Main Results:

  • 135 patients (median age 32.4 years) underwent RVOTR with SPAR; 129 had prior surgery.
  • Overall survival was 93.3%. Freedom from reintervention at 10 years was 90.7%.
  • Moderate stenosis/insufficiency occurred in 22.2%/7.7% at 10 years. Endocarditis in 2.9%.

Conclusions:

  • SPAR demonstrates excellent midterm to long-term durability in RVOTR.
  • The prosthesis is associated with low rates of endocarditis and high freedom from reintervention.
  • SPAR is a durable option for right ventricular outflow tract reconstruction with favorable outcomes.