The First Fifty Consecutive Bentall Operations with a Prefabricated Tissue-Valved Aortic Conduit: A Single-Center Experience

作者:Baraki Hassina; Al Ahmad Ammar; Sarikouch Samir; Koigeldiev Nurbol; Khaladj Nawid; Hagl Christian; Pichlmaier Maximillian; Haverich Axel; Shrestha Malakh*
来源:Journal of Heart Valve Disease, 2010, 19(3): 286-291.

摘要

Background and aim of the study: Composite replacement is the standard treatment for the repair of aortic aneurysm with aortic valve pathology. With improved long-term durability and no requirement for long-term anticoagulation, tissue-valved conduits have become increasingly popular. Herein are reported the results achieved with 50 consecutive 'Bentall' operations, using the first commercially available prefabricated stentless tissue-valved conduit (Vascutek BioValsalva).
Methods: Between September 2007 and September 2009, a total of 50 patients (10 females, 40 males; mean age 65 7 years) received a BioValsalva conduit. Concomitant procedures included coronary artery bypass grafting (CABG; n = 15), other valve (n = 5), and aortic arch replacement with circulatory arrest (n = 20; three of these had an additional frozen elephant trunk). Four of the procedures were re-operations. A six-month follow up with echocardiography and clinical examination was completed in 25 patients. Results: The 30-day mortality was 8% (4/50). Three of these patients underwent concomitant procedures. The cardiopulmonary bypass (CPB) and cross-clamp times were 178 +/- 30 min and 106 +/- 7 min, respectively. The triple-layered vascular graft proved to be hemostatic, without suture-line bleeding. Both, the initial and follow up echocardiography showed no valvular insufficiency, with a mean gradient of 13 5 mmHg. All patients were in NYHA class I-II.
Conclusion: The BioValsalva prefabricated tissue-valved conduit showed very good early results. The ischemic time required to construct a 'home-made' stentless tissue-valved conduit was eliminated, thus reducing the cross-clamp time. The conduit also offered the hemodynamic advantages of a stentless valve.

  • 出版日期2010-5