Predictors of Outcome in Patients with Prosthetic Valve Endocarditis (PVE) and Potential Advantages of Homograft Aortic Root Replacement for Prosthetic Ascending Aortic Valve-Graft Infections

1990 ◽  
Vol 5 (1) ◽  
pp. 53-62 ◽  
Author(s):  
D. CRAIG MILLER
Keyword(s):  
Aortic Valve ◽  
Aortic Root ◽  
Prosthetic Valve ◽  
Prosthetic Valve Endocarditis ◽  
Aortic Root Replacement ◽  
Predictors Of Outcome

Long-term mortality in patients with infective endocarditis who undergo aortic root replacement versus isolated aortic valve replacement

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
F Kyhl ◽  
A.D Jensen ◽  
L Oestergaard ◽  
M Smerup ◽  
H Dagnegaard ◽  
...  
Keyword(s):  
Infective Endocarditis ◽  
Aortic Valve ◽  
Aortic Valve Replacement ◽  
Aortic Root ◽  
Prosthetic Valve ◽  
Prosthetic Valve Endocarditis ◽  
Aortic Root Replacement ◽  
Significant Difference ◽  
Long Term Mortality

Abstract Background Infective endocarditis (IE) with involvement of the aortic root (root abscess or aortic prosthetic valve endocarditis (PVE)) is associated with high mortality and morbidity, and it often requires root replacement. IE-guidelines recommend surgery in patients with aortic root involvement (class B recommendation), but the surgical technique is challenging, and the perioperative risk is high. Long-term data are sparse for these high-risk patients and may help better select appropriate patients for surgery. Purpose We set out to investigate the short- and long-term mortality for patients with destructive aortic valve endocarditis who underwent aortic root replacement. For comparison, we included those who underwent isolated aortic valve replacement for IE (isolated AVR). Methods We included patients with first-time IE from 2000 to 2016 who underwent aortic valve surgery identified from The Eastern Danish Thoracic surgery database. Patient characteristics were identified by cross-linking Danish nationwide databases. Patients who underwent aortic root replacement were compared with those who underwent isolated AVR. Kaplan-Meier plots and multivariable Cox regression analyses were used to estimate and compare the associated 30-days and 10-year mortality risks between groups. Results We included 368 patients with aortic valve IE who underwent AVR surgery; 126 patients underwent aortic root replacement and 242 underwent isolated AVR. Median age for root replacement patients was 65.4 years (interquartile range [IQR] 56.2–73.0) compared with 62.1 years (IQR 52.3–71.6) for isolated AVR patients. In the root replacement group, 40.5% had prosthetic valve endocarditis (PVE), whereas 6.6% had PVE in the isolated AVR group. 30-day mortality was 12.7% (CI95: 7.6%-19.2%) in the root replacement group and 7.0% (CI95: 4.3%-10.7%) in the isolated AVR group (P=0.06). Estimated 10-year mortality was 54.4% (CI95: 40.3%-67.6%) in the root replacement group and 45.3% (CI95: 35.7%-54.5%) (P=0.07) after isolated AVR (figure 1). At up to 10 years follow-up, there was no significant difference in adjusted mortality between the groups, adjusted HR=1.34 (CI 95: 0.90–2.00). Conclusion Patients with IE who underwent aortic root replacement surgery more often had a prosthetic heart valve, were older, and were more often male. There was no significant difference in long-term mortality between the groups. Nonetheless, long-term mortality was high – 50% of patients died by 10 years, and our results underline the need for stringent patient selection. Figure 1 Funding Acknowledgement Type of funding source: None

Aortic root replacement with cryopreserved allograft for prosthetic valve endocarditis

2002 ◽  
Vol 74 (3) ◽  
pp. 650-659 ◽  
Author(s):  
Joseph F. Sabik ◽  
Bruce W. Lytle ◽  
Eugene H. Blackstone ◽  
Antonino G.M. Marullo ◽  
Gosta B. Pettersson ◽  
...  
Keyword(s):  
Aortic Root ◽  
Prosthetic Valve ◽  
Prosthetic Valve Endocarditis ◽  
Aortic Root Replacement

Initial experience with xenograft bioconduit for the treatment of complex prosthetic valve endocarditis

Perfusion ◽  
2017 ◽  
Vol 32 (5) ◽  
pp. 383-388 ◽  
Author(s):  
Apostolos Roubelakis ◽  
Dimos Karangelis ◽  
Syed Sadeque ◽  
Bobby Yanagawa ◽  
Amit Modi ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Aortic Root ◽  
Prosthetic Valve ◽  
High Risk Patient ◽  
Recurrent Infection ◽  
Length Of Hospital Stay ◽  
Prosthetic Valve Endocarditis ◽  
Biological Tissues ◽  
Aortic Root Abscess ◽  
The Mean

Introduction: The treatment of complex prosthetic valve endocarditis (PVE) with aortic root abscess remains a surgical challenge. Several studies support the use of biological tissues to minimize the risk of recurrent infection. We present our initial surgical experience with the use of an aortic xenograft conduit for aortic valve and root replacement. Methods: Between October 2013 and August 2015, 15 xenograft bioconduits were implanted for complex PVE with abscess (13.3% female). In 6 patients, concomitant procedures were performed: coronary bypass (n=1), mitral valve replacement (n=5) and tricuspid annuloplasty (n=1). The mean age at operation was 60.3±15.5 years. The mean Logistic European system for cardiac operating risk evaluation (EuroSCORE) was 46.6±23.6. The median follow-up time was 607±328 days (range: 172-1074 days). Results: There were two in-hospital deaths (14.3% mortality), two strokes (14.3%) and seven patients required permanent pacemaker insertion for conduction abnormalities (46.7%). The mean length of hospital stay was 26 days. At pre-discharge echocardiography, the conduit mean gradient was 9.3±3.3mmHg and there was either none (n=6), trace (n=6) or mild aortic insufficiency (n=1). There was no incidence of mid-term death, prosthesis-related complications or recurrent endocarditis. Conclusions: Xenograft bioconduits may be safe and effective for aortic valve and root replacement for complex PVE with aortic root abscess. Although excess early mortality reflects the complexity of the patient population, there was good valve hemodynamics, with no incidence of recurrent endocarditis or prosthesis failure in the mid-term. Our data support the continued use and evaluation of this biological prosthesis in this high-risk patient cohort.

scholarly journals Homograft Aortic Root Replacement with Saphenous Vein Graft Hemi-Cabrol for Prosthetic Aortic Valve Endocarditis

Aorta ◽  
2015 ◽  
Vol 03 (02) ◽  
pp. 81-85 ◽  
Author(s):  
Ioannis Dimarakis ◽  
Wilfred Wooldridge ◽  
Isaac Kadir
Keyword(s):  
Aortic Valve ◽  
Saphenous Vein ◽  
Prosthetic Valve ◽  
Saphenous Vein Graft ◽  
Prosthetic Valve Endocarditis ◽  
Aortic Root Replacement ◽  
Coronary Ostium ◽  
Long Saphenous Vein ◽  
Prosthetic Aortic Valve ◽  
Aortic Homograft

AbstractA 44-year-old female presented with prosthetic valve endocarditis with periannular abscess involving the left coronary ostium. We describe cryopreserved aortic homograft root replacement with hemi-Cabrol reimplantation of the left coronary ostium using the long saphenous vein.

Emergency aortic root replacement with the Bioconduit stentless aortic valve conduit

2020 ◽  
Vol 25 (6) ◽  
pp. 2055-2059
Author(s):  
ADRIAN TULIN ◽  
◽  
OVIDIU STIRU ◽  
MIRUNA LUANA MIULESCU ◽  
LAURA RADUCU ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Aortic Regurgitation ◽  
Aortic Root ◽  
Aortic Root Replacement ◽  
Bentall Operation ◽  
Severe Aortic Regurgitation ◽  
Valve Conduit ◽  
Successful Case ◽  
Valved Conduit

This report concerns a 73-year-old woman who presented with asymptomatic aortic root an-eurysm with severe aortic regurgitation. The purpose of this article is to present our first successful case for emergency aortic root replacement (Bentall operation) that involves annular implantation of a pericardial valved conduit (Bioconduit TM, Biointegral Surgical, Inc., Ontario, Canada) and to discuss some essential technical clue issues related to this approach.

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