O Wendler1, V Dzindzibadze, F Langer, S El Dsoki, H J Schäfers. 1. Department of Thoracic and Cardiovascular Surgery, University Hospital Homburg/Saar, Kirrberger Strasse 1, 66421 Homburg/Saar, Germany. chowen@med-rrz.uni-sb.de
Abstract
BACKGROUND: In aortic valve replacement stentless bioprostheses results in improved hemodynamic function compared to stented valves. Using the root replacement technique even larger prostheses are implantable. We present our experience with stentless bioprostheses implanted in the "full-root" technique. PATIENTS AND METHODS: Between 01/1997 and 12/2000, 149 patients underwent root replacement with a stentless xenograft (age 70 +/- 9y, women 52 %, ejection-fraction 58 +/- 15 %). Isolated stenosis was present in 34 %, incompetence in 24 %, and mixed disease in 42 % of patients. Bacterial endocarditis was found in 16 %, and 3 patients suffered from acute aortic dissection. RESULTS: Mean bypass time was 118 +/- 45 min, ischemic time 83 +/- 26 min and operating time 201 +/- 62 min. Concomitant procedures were CABG (32 %), replacement of ascending aorta (22 %) and aortic arch (13 %), mitral valve repair (6.7 %), and carotid thrombendarterectomy (1.3 %). Total in-hospital mortality was 6.7 %, with a 1.8 % mortality rate for patients with isolated aortic valve disease. CONCLUSION: Aortic valve replacement using stentless bioprostheses in the root replacement technique is a safe surgical option. In patients with small aortic roots or ring abscesses it guarantees remodelling of the aortic annulus.
BACKGROUND: In aortic valve replacement stentless bioprostheses results in improved hemodynamic function compared to stented valves. Using the root replacement technique even larger prostheses are implantable. We present our experience with stentless bioprostheses implanted in the "full-root" technique. PATIENTS AND METHODS: Between 01/1997 and 12/2000, 149 patients underwent root replacement with a stentless xenograft (age 70 +/- 9y, women 52 %, ejection-fraction 58 +/- 15 %). Isolated stenosis was present in 34 %, incompetence in 24 %, and mixed disease in 42 % of patients. Bacterial endocarditis was found in 16 %, and 3 patients suffered from acute aortic dissection. RESULTS: Mean bypass time was 118 +/- 45 min, ischemic time 83 +/- 26 min and operating time 201 +/- 62 min. Concomitant procedures were CABG (32 %), replacement of ascending aorta (22 %) and aortic arch (13 %), mitral valve repair (6.7 %), and carotid thrombendarterectomy (1.3 %). Total in-hospital mortality was 6.7 %, with a 1.8 % mortality rate for patients with isolated aortic valve disease. CONCLUSION: Aortic valve replacement using stentless bioprostheses in the root replacement technique is a safe surgical option. In patients with small aortic roots or ring abscesses it guarantees remodelling of the aortic annulus.