Literature DB >> 27048273

Comparison of mid-term haemodynamic performance between the BioValsalva and the BioIntegral valved conduits after aortic root replacement.

Daniel Wendt1, Ayman Raweh2, Stephan Knipp2, Mohammed El Gabry2, Mareike Eißmann3, Daniel Sebastian Dohle2, Konstantinos Tsagakis2, Matthias Thielmann2, Heinz Jakob2, Jaroslav Benedik2.   

Abstract

OBJECTIVES: We retrospectively compared the haemodynamic performance of the BioValsalva (BV) and BioIntegral (BI) biological aortic-valved conduits in the aortic root position.
METHODS: Between July 2008 and June 2014, a total of 55 patients underwent aortic root replacement using the BV conduit (n = 27) or the BI conduit (n = 28). The primary study endpoints were haemodynamic performance during follow-up, including mean pressure gradients (MPGs) and effective orifice areas (EOAs). Secondary study endpoints were early postoperative outcomes within 30 days and survival.
RESULTS: Both groups did not differ in regard to demographics (BV: median age 71 years, 70.4% female; BI: median age 66 years, 85.7% female, P = 0.15 and P = 0.17) and risk profile (median EuroSCORE-II BV: 3.8 vs 5.3% for BI, P = 0.38). A total of 20% of the total patients (BV 5/27, 18.5% vs BI 6/28, 21.4%) presented with acute type-A aortic dissection. During follow-up, both groups showed no difference in MPGs for all valve sizes [BV, 11.0 mmHg (8.3-14.8 mmHg) vs BI, 11.5 mmHg (9.0-13.0), P = 0.82]. Similar results were achieved for EOAs for all valve sizes [BV, 1.85 cm(2) (1.55-2.21) vs BI, 1.80 cm(2) (1.64-1.83), P = 0.24]. Moreover, there was no statistically significant difference in aortic regurgitation (AR) with none/trace AR in (21/23) 91.3% in BV patients versus (16/21) 76.2% in BI patients (P = 0.23) at follow-up. Both groups showed a high rate of concomitant procedures (BV: 59.3% vs BI: 71.4%, P = 0.40) and emergency indication (BV: 18.5% vs BI: 21.4%, P = 0.79), resulting in an overall 30-day mortality rate of 7.3% (4/55 patients).
CONCLUSIONS: The present small single-centre study is one of the first to evaluate and compare the BioValsalva and BioIntegral biological aortic-valved conduit in the aortic root position. Both conduits showed optimal haemodynamic results with a low incidence of aortic regurgitation.
© The Author 2016. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.

Entities:  

Keywords:  Aortic valve; Bentall procedure; BioConduit; BioIntegral; BioValsalva; Biological conduit; Bioprosthesis; No-react valve

Mesh:

Year:  2016        PMID: 27048273      PMCID: PMC4986743          DOI: 10.1093/icvts/ivw066

Source DB:  PubMed          Journal:  Interact Cardiovasc Thorac Surg        ISSN: 1569-9285


  13 in total

1.  The first fifty consecutive Bentall operations with a prefabricated tissue-valved aortic conduit: a single-center experience.

Authors:  Hassina Baraki; Ammar Al Ahmad; Samir Sarikouch; Nurbol Koigeldiev; Nawid Khaladj; Christian Hagl; Maximillian Pichlmaier; Axel Haverich; Malakh Shrestha
Journal:  J Heart Valve Dis       Date:  2010-05

2.  Re-creation of a sinuslike graft expansion in Bentall procedure reduces stress at the coronary button anastomoses: A finite element study.

Authors:  Luca Weltert; Ruggero De Paulis; Raffaele Scaffa; Daniele Maselli; Alessandro Bellisario; Stefano D'Alessandro
Journal:  J Thorac Cardiovasc Surg       Date:  2009-01-26       Impact factor: 5.209

3.  Bio-Valsalva prosthesis: 'new' conduit for 'old' patients.

Authors:  Roberto Di Bartolomeo; Luca Botta; Alessandro Leone; Emanuele Pilato; Sofia Martin-Suarez; Massimo Bacchini; Davide Pacini
Journal:  Interact Cardiovasc Thorac Surg       Date:  2008-09-18

4.  Aortic regurgitation after valve-sparing aortic root replacement: modes of failure.

Authors:  Takanori Oka; Yutaka Okita; Masamichi Matsumori; Kenji Okada; Hitoshi Minami; Hiroshi Munakata; Takeshi Inoue; Akiko Tanaka; Toshihito Sakamoto; Atsushi Omura; Takuo Nomura
Journal:  Ann Thorac Surg       Date:  2011-09-25       Impact factor: 4.330

5.  A technique for complete replacement of the ascending aorta.

Authors:  H Bentall; A De Bono
Journal:  Thorax       Date:  1968-07       Impact factor: 9.139

6.  Radical replacement of the aortic root in acute type A dissection: indications and outcome.

Authors:  M A Ergin; J McCullough; J D Galla; S L Lansman; R B Griepp
Journal:  Eur J Cardiothorac Surg       Date:  1996       Impact factor: 4.191

7.  Aortic root replacement with a new stentless aortic valve xenograft conduit: preliminary hemodynamic and clinical results.

Authors:  Thierry P Carrel; Pascal Berdat; Lars Englberger; Friedrich Eckstein; Franz Immer; Christian Seiler; Beat Kipfer; Jürg Schmidli
Journal:  J Heart Valve Dis       Date:  2003-11

8.  Aortic root reconstruction with a bioprosthetic valved conduit: a consecutive series of 275 procedures.

Authors:  Christian D Etz; Tobias M Homann; Neil Rane; Carol A Bodian; Gabriele Di Luozzo; Konstadinos A Plestis; David Spielvogel; Randall B Griepp
Journal:  J Thorac Cardiovasc Surg       Date:  2007-05-02       Impact factor: 5.209

9.  Further experience with the "no-react" bioprosthesis in patients with active infective endocarditis: 11-year single center results in 402 patients.

Authors:  Michele Musci; Aref Amiri; Henryk Siniawski; Julia Stein; Yuguo Weng; Roland Hetzer
Journal:  Thorac Cardiovasc Surg       Date:  2013-04-05       Impact factor: 1.827

10.  Totally biological composite aortic stentless valved conduit for aortic root replacement: 10-year experience.

Authors:  Manuel Galiñanes; Ayo Meduoye; Ignacio Ferreira; Andrzej Sosnowski
Journal:  J Cardiothorac Surg       Date:  2011-06-23       Impact factor: 1.637

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