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Related Experiment Videos

Aortic root replacement with human tissue valves in aortic valve endocarditis

K Dossche1, A Brutel de la Rivière, W Morshuis

  • 1Department of Cardiopulmonary Surgery, Sint-Antonius Hospital, Nieuwegein, Netherlands.

European Journal of Cardio-Thoracic Surgery : Official Journal of the European Association for Cardio-Thoracic Surgery
|July 1, 1997
PubMed
Summary

Aortic root replacement using allografts or pulmonary autografts is effective for native and prosthetic aortic valve endocarditis. Key risk factors for hospital death include age, functional class, and renal insufficiency.

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Area of Science:

  • Cardiovascular Surgery
  • Infective Endocarditis
  • Aortic Valve Disease

Background:

  • Native and prosthetic aortic valve endocarditis present complex surgical challenges.
  • Aortic root replacement is a critical intervention for severe cases.

Purpose of the Study:

  • To evaluate aortic allograft and pulmonary autograft aortic root replacement in patients with native and prosthetic aortic valve endocarditis.
  • To identify risk factors associated with hospital mortality in these patients.

Main Methods:

  • A retrospective study of 59 patients (27 native, 32 prosthetic) undergoing aortic root replacement with human tissue valves from 1989-1996.
  • Cryopreserved allografts were predominantly used; pulmonary autografts were also employed.
  • Univariate analysis was performed to assess risk factors for hospital death.

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Main Results:

  • Hospital mortality was 8.5%.
  • Significant risk factors for hospital mortality included advanced age, preoperative New York Heart Association functional class, and pre- and postoperative renal insufficiency.
  • Major complications included allograft failure, technical failure, and false aneurysm formation (each 2%).
  • Five-year survival was 88.8%, and freedom from recurrent endocarditis was 98.1%.

Conclusions:

  • Aortic allograft aortic root replacement is a valuable and effective technique for life-threatening native and prosthetic aortic valve endocarditis involving the annular and peri-annular regions.
  • The procedure offers favorable long-term survival and low rates of recurrent infection.