Viable Cryopreserved Aortic Homograft for Aortic Valve Endocarditis and Annular Abscesses

Six consecutive patients with active aortic valve endocarditis, including 2 with extensive subannular aortic root abscess, were successfully treated with viable cryopreserved homograft aortic valve replacement. Two patients required extensive aortic root reconstruction with an appropriately trimmed...

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Bibliographic Details
Published inThe Annals of thoracic surgery Vol. 48; no. 3; pp. 365 - 370
Main Authors Zwischenberger, Joseph B., Shalaby, Tarek Zaghloul, Conti, Vincent R.
Format Journal Article
LanguageEnglish
Published New York, NY Elsevier Inc 01.09.1989
Elsevier Science
Subjects
Abscess - surgery
Adult
Aortic Valve - transplantation
Biological and medical sciences
Cardiology. Vascular system
Endocardial and cardiac valvular diseases
Endocarditis, Bacterial - surgery
Female
Freezing
Heart
Heart Valve Diseases - surgery
Humans
Male
Medical sciences
Methods
Middle Aged
Organ Preservation
Postoperative Complications
Ascending aorta
Human
Abscess
Homograft
Cardiovascular disease
Replacement
Infection
Cardiac valvular disease
Cryopreservation
Follow up study
Surgery
Endocardial disease
Endocarditis
Bacteriosis
Chlamydiosis
Aortic valve
Aortic disease
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Summary:Six consecutive patients with active aortic valve endocarditis, including 2 with extensive subannular aortic root abscess, were successfully treated with viable cryopreserved homograft aortic valve replacement. Two patients required extensive aortic root reconstruction with an appropriately trimmed aortic homograft to cover large abscess cavities. All patients showed resolution of infection with no perioperative mortality or clinically significant morbidity. Three patients had a minor degree of aortic insufficiency on postoperative echo-Doppler study. On follow-up at 6 to 48 months, all patients were in New York Heart Association functional class I. The resistance of the unstented homograft to infection makes it an attractive choice for patients requiring aortic valve replacement for active endocarditis. The results of surgical intervention in patients with extensive aortic root involvement may be further improved by the flexibility afforded by the homograft to be “custom-fit” to the abnormal aortic root and the ability to achieve secure valve fixation without use of prosthetic material.
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ISSN:0003-4975
1552-6259
DOI:10.1016/S0003-4975(10)62858-5