Surgical options for aortic root replacement in destructive endocarditis
Rev. bras. cir. cardiovasc
;
35(3): 265-273, May-June 2020. tab, graf
Artigo
em Inglês
| LILACS, SES-SP
| ID: biblio-1137265
ABSTRACT
Abstract 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.
Texto completo:
DisponíveL
Índice:
LILACS (Américas)
Assunto principal:
Bioprótese
/
Próteses Valvulares Cardíacas
/
Implante de Prótese de Valva Cardíaca
/
Endocardite
Tipo de estudo:
Estudo observacional
/
Estudo prognóstico
/
Fatores de risco
Limite:
Animais
/
Feminino
/
Humanos
/
Masculino
Idioma:
Inglês
Revista:
Rev. bras. cir. cardiovasc
Ano de publicação:
2020
Tipo de documento:
Artigo
Instituição/País de afiliação:
Oldenburg University Hospital/DE
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