Can Vuran1, Paul Simon2, Gregor Wollenek2, Emre Ozker2, Erdal Aslım3. 1. Department of Cardiovascular Surgery, İstanbul Medical Application and Research Center, Başkent University, İstanbul, Turkey. 2. Department of Thoracic and Cardiovascular Surgery, Faculty of Medicine, Vienna University, Vienna, Austria. 3. Clinic of Cardiovascular Surgery, Acıbadem Hospital, İstanbul, Turkey.
Abstract
OBJECTIVE: The aim of this study was to analyze the midterm clinical results of aortic valve replacement with cryopreserved homografts. MATERIALS AND METHODS: Aortic valve replacement was performed in 40 patients with cryopreserved homograft. The indications were aortic valve endocarditis in 20 patients (50%), truncus arteriosus in 6 patients (15%), and re-stenosis or regurtitation after aortic valve reconstruction in 14 (35%) patients. The valve sizes ranged from 10 to 27mm. A full root replacement technique was used for homograft replacement in all patients. RESULTS: The 30-day postoperative mortality rate was 12.5% (5 patients). There were four late deaths. Only one of them was related to cardiac events. Overall mortality was 22.5%. Thirty-three patients were followed up for 67±26 months. Two patients needed reoperation due to aortic aneurysm caused by endocarditis. The mean transvalvular gradient significantly decreased after valve replacement (p<0.003). The last follow up showed that the 27 (82%) patients had a normal left ventricular function. CONCLUSION: Cryopreserved homografts are safe alternatives to mechanical valves that can be used when there are proper indications. Although it has a high perioperative mortality rate, cryopreserved homograft implantation is an alternative for valve replacement, particularly in younger patients and for complex surgical problems such as endocarditis that must be minimalized.
OBJECTIVE: The aim of this study was to analyze the midterm clinical results of aortic valve replacement with cryopreserved homografts. MATERIALS AND METHODS: Aortic valve replacement was performed in 40 patients with cryopreserved homograft. The indications were aortic valve endocarditis in 20 patients (50%), truncus arteriosus in 6 patients (15%), and re-stenosis or regurtitation after aortic valve reconstruction in 14 (35%) patients. The valve sizes ranged from 10 to 27mm. A full root replacement technique was used for homograft replacement in all patients. RESULTS: The 30-day postoperative mortality rate was 12.5% (5 patients). There were four late deaths. Only one of them was related to cardiac events. Overall mortality was 22.5%. Thirty-three patients were followed up for 67±26 months. Two patients needed reoperation due to aortic aneurysm caused by endocarditis. The mean transvalvular gradient significantly decreased after valve replacement (p<0.003). The last follow up showed that the 27 (82%) patients had a normal left ventricular function. CONCLUSION: Cryopreserved homografts are safe alternatives to mechanical valves that can be used when there are proper indications. Although it has a high perioperative mortality rate, cryopreserved homograft implantation is an alternative for valve replacement, particularly in younger patients and for complex surgical problems such as endocarditis that must be minimalized.
Authors: S Westaby; N Amarasena; V Long; A Prothero; G A Amarasena; A P Banning; R Pillai; O Ormerod Journal: Ann Thorac Surg Date: 1995-12 Impact factor: 4.330
Authors: Simone A Huygens; Mostafa M Mokhles; Milad Hanif; Jos A Bekkers; Ad J J C Bogers; Maureen P M H Rutten-van Mölken; Johanna J M Takkenberg Journal: Eur J Cardiothorac Surg Date: 2016-03-29 Impact factor: 4.191