Bibliographic Details
| Title: |
Surgical Options for Aortic Root Replacement in Destructive Endocarditis |
| Authors: |
Szczechowicz, Marcin, Weymann, Alexander, Mkalaluh, Sabreen, Mashhour, Ahmed, Zhigalov, Konstantin, Easo, Jerry |
| Source: |
Brazilian Journal of Cardiovascular Surgery. June 2020 35(3) |
| Publisher Information: |
Sociedade Brasileira de Cirurgia Cardiovascular, 2020. |
| Publication Year: |
2020 |
| Subject Terms: |
Endocarditis, Bacterial, Aortic Valve, Reoperation, Heterografts, Transplantation, Heterologous, Stents, Allografts |
| More Details: |
Objective: To analyze patients’ preoperative characteristics, surgical data, postoperative courses, and short- and long-term outcomes after implantation of different full-root prostheses for destructive aortic valve endocarditis. Methods: Between 1999 and 2018, 80 patients underwent aortic root replacement due to infective endocarditis in our institution. We analyzed the abovementioned data with standard statistical methods. Results: The Freestyle stentless porcine prostheses were implanted in 53 (66.25%) patients, biological valve conduits in 13 (16.25%), aortic root homografts in nine (11.25%), and mechanical valve conduits in five (6.25%). There were no significant preoperative differences between the groups. The incidence of postoperative complications and intensive care unit length of stay did not differ significantly between the groups. The 30-day mortality rate was low among Freestyle patients (n=8, 15.1%) and high in the mechanical conduit cohort (n=3, 60%), though with borderline statistical significance (P=0.055). The best mean survival rates were observed after homograft (13.7 years) and stentless prosthesis (8.1 years) implantation, followed by biological (2.8 years) and mechanical (1.4 years) conduits (P=0.014). The incidence of reoperations was low in the mechanical conduit group (0) and stentless bioroot group (n=1, 1.9%), but two (15.4%) patients with biological conduits and three (33.3%) patients with homografts required reoperations in the investigated follow-up period (P=0.005). Conclusion: In patients with the destructive form of aortic valve endocarditis, homografts and stentless porcine xenografts offer better survival rates than stented valve conduits; however, the reoperation rate among patients who received homograft valves is high. |
| Document Type: |
article |
| File Description: |
text/html |
| Language: |
English |
| ISSN: |
0102-7638 |
| DOI: |
10.21470/1678-9741-2020-0020 |
| Access URL: |
http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0102-76382020000300009 |
| Rights: |
info:eu-repo/semantics/openAccess |
| Accession Number: |
edssci.S0102.76382020000300009 |
| Database: |
SciELO |
