OBJECTIVE: The study objective was to provide evidence for choosing a bioprosthesis in treating patients with active aortic valve endocarditis. METHODS: From 1998 to 2017, 265 patients with active aortic valve endocarditis underwent aortic valve replacement with a stented valve (n = 97, 37%) or a stentless valve (n = 168, 63%) with further breakdown into inclusion technique (n = 142, 85%) or total root replacement (n = 26, 15%). Data were obtained from the Society of Thoracic Surgeons database aided with chart review, surveys, and National Death Index data. RESULTS: The median age of patients was 53 years (43-56) in the stented group and 57 years (44-66) in the stentless group. The stented and stentless groups had high rates of heart failure (54% and 40%), liver disease (16% and 7.7%), prosthetic valve endocarditis (14% and 48%), root abscess (38% and 70%), and concomitant ascending aorta procedures (6.2% and 22%), respectively. The stentless group required permanent pacemakers in 11% of cases. Operative mortality was similar between groups (6.2% and 7.1%). The 5-year survival was 52% and 63% in the stented and stentless groups, respectively. Significant risk factors for long-term mortality included liver disease (hazard ratio, 2.38), previous myocardial infarction (hazard ratio, 1.64), congestive heart failure (hazard ratio, 1.63), and renal failure requiring dialysis (hazard ratio, 4.37). The 10-year cumulative incidence of reoperation was 12% and 3.4% for the stented and stentless groups, respectively. The 10-year freedom from reoccurrence of aortic valve endocarditis was 88% for the stented and 98% for the stentless groups. CONCLUSIONS: Both stented and stentless aortic valves are appropriate conduits for replacement of active aortic valve endocarditis for select patients.
OBJECTIVE: The study objective was to provide evidence for choosing a bioprosthesis in treating patients with active aortic valve endocarditis. METHODS: From 1998 to 2017, 265 patients with active aortic valve endocarditis underwent aortic valve replacement with a stented valve (n = 97, 37%) or a stentless valve (n = 168, 63%) with further breakdown into inclusion technique (n = 142, 85%) or total root replacement (n = 26, 15%). Data were obtained from the Society of Thoracic Surgeons database aided with chart review, surveys, and National Death Index data. RESULTS: The median age of patients was 53 years (43-56) in the stented group and 57 years (44-66) in the stentless group. The stented and stentless groups had high rates of heart failure (54% and 40%), liver disease (16% and 7.7%), prosthetic valve endocarditis (14% and 48%), root abscess (38% and 70%), and concomitant ascending aorta procedures (6.2% and 22%), respectively. The stentless group required permanent pacemakers in 11% of cases. Operative mortality was similar between groups (6.2% and 7.1%). The 5-year survival was 52% and 63% in the stented and stentless groups, respectively. Significant risk factors for long-term mortality included liver disease (hazard ratio, 2.38), previous myocardial infarction (hazard ratio, 1.64), congestive heart failure (hazard ratio, 1.63), and renal failure requiring dialysis (hazard ratio, 4.37). The 10-year cumulative incidence of reoperation was 12% and 3.4% for the stented and stentless groups, respectively. The 10-year freedom from reoccurrence of aortic valve endocarditis was 88% for the stented and 98% for the stentless groups. CONCLUSIONS: Both stented and stentless aortic valves are appropriate conduits for replacement of active aortic valve endocarditis for select patients.
Authors: O Lund; V Chandrasekaran; R Grocott-Mason; H Elwidaa; R Mazhar; A Khaghani; A Mitchell; C Ilsley; M H Yacoub Journal: J Thorac Cardiovasc Surg Date: 1999-01 Impact factor: 5.209
Authors: John G Byrne; Katayoun Rezai; Juan A Sanchez; Richard A Bernstein; Eric Okum; Marzia Leacche; Jorge M Balaguer; Shyam Prabhakaran; Charles R Bridges; Robert S D Higgins Journal: Ann Thorac Surg Date: 2011-06 Impact factor: 4.330
Authors: Joon Bum Kim; Julius I Ejiofor; Maroun Yammine; Janice M Camuso; Conor W Walsh; Masahiko Ando; Serguei I Melnitchouk; James D Rawn; Marzia Leacche; Thomas E MacGillivray; Lawrence H Cohn; John G Byrne; Thoralf M Sundt Journal: J Thorac Cardiovasc Surg Date: 2016-01-23 Impact factor: 5.209
Authors: Sami El-Dalati; Daniel Cronin; Michael Shea; Richard Weinberg; James Riddell; Laraine Washer; Emily Shuman; James Burke; Sadhana Murali; Christopher Fagan; Twisha Patel; Kirra Ressler; George Michael Deeb Journal: Am J Med Date: 2019-09-12 Impact factor: 4.965
Authors: Bo Yang; Juan Caceres; Linda Farhat; Tan Le; Bailey Brown; Emma St Pierre; Xiaoting Wu; Karen M Kim; Himanshu J Patel; G Michael Deeb Journal: J Thorac Cardiovasc Surg Date: 2020-04-13 Impact factor: 6.439
Authors: Andreas Schaefer; Jannis Dickow; Gerhard Schoen; Sumi Westhofen; Lisa Kloss; Tarik Al-Saydali; Hermann Reichenspurner; Sebastian A Philipp; Christian Detter Journal: PLoS One Date: 2018-01-16 Impact factor: 3.240