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

• Published in: Interactive cardiovascular and thoracic surgery Vol. 23; no. 1; pp. 112 - 117
• Main Authors: Wendt, Daniel, Raweh, Ayman, Knipp, Stephan, El Gabry, Mohammed, Eißmann, Mareike, Dohle, Daniel Sebastian, Tsagakis, Konstantinos, Thielmann, Matthias, Jakob, Heinz, Benedik, Jaroslav
• Format: Journal Article
• Language: English
• Published: England Oxford University Press 01.07.2016
• Subjects: Adult; Aged; Aneurysm, Dissecting - physiopathology; Aneurysm, Dissecting - surgery; Aortic Aneurysm, Thoracic - physiopathology; Aortic Aneurysm, Thoracic - surgery; Aortic Valve Insufficiency - physiopathology; Aortic Valve Insufficiency - surgery; Bioprosthesis; Female; Heart Valve Prosthesis; Heart Valve Prosthesis Implantation; Hemodynamics; Humans; Male; Middle Aged; ORIGINAL ARTICLES; Prosthesis Design; Retrospective Studies; BioValsalva; BioIntegral; Bentall procedure; No-react valve; Bioprosthesis; Aortic valve; BioConduit; Biological conduit
• ISSN: 1569-9293; 1569-9285
• DOI: 10.1093/icvts/ivw066

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 cm2 (1.55–2.21) vs BI, 1.80 cm2 (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.