The first fifty consecutive Bentall operations with a prefabricated tissue-valved aortic conduit: a single-center experience

• Published in: The Journal of heart valve disease Vol. 19; no. 3; p. 286
• Main Authors: Baraki, Hassina, Al Ahmad, Ammar, Sarikouch, Samir, Koigeldiev, Nurbol, Khaladj, Nawid, Hagl, Christian, Pichlmaier, Maximillian, Haverich, Axel, Shrestha, Malakh
• Format: Journal Article
• Language: English
• Published: England 01.05.2010
• Subjects: Adult; Aged; Aged, 80 and over; Aortic Aneurysm - epidemiology; Aortic Aneurysm - surgery; Blood Vessel Prosthesis; Blood Vessel Prosthesis Implantation; Comorbidity; Female; Heart Valve Diseases - epidemiology; Heart Valve Diseases - surgery; Heart Valve Prosthesis; Heart Valve Prosthesis Implantation; Humans; Male; Middle Aged; Prosthesis Design
• ISSN: 0966-8519

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). 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. 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. 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.