Abstract 10986: Treatment of Aortic Valve Endocarditis With Stented or Stentless Valve: Short Term and Long Term Outcomes

• Published in: Circulation (New York, N.Y.) Vol. 140; no. Suppl_1 Suppl 1; p. A10986
• Main Authors: Yang, Bo, Clemence, Jeffrey, Farhat, Linda, Brown, Bailey, St. Pierre, Emma, Le, Tan D, Gonzalez, Evelyn, Caceres, Juan, Ren, Tom, Makkinejad, Alexander, Wu, Xiaoting, Pagani, Francis D, Haft, Jonathan, TANG, Paul C, Romano, Matthew A, Prager, Richard L, Bolling, Steven F, Kim, Karen, Patel, Himanshu J, Deeb, G Michael
• Format: Journal Article
• Language: English
• Published: by the American College of Cardiology Foundation and the American Heart Association, Inc 19.11.2019
• ISSN: 0009-7322; 1524-4539
• DOI: 10.1161/circ.140.suppl_1.10986

IntroductionTo provide evidence of choosing bioprosthesis in treating patients with active aortic valve endocarditis (AVE).HypothesisWe hypothesize stented and stentless aortic valves are equally effective treating AVE.MethodsFrom 1997-2017, 282 patients underwent treatment of AVE with either a stented valve (n=107, 38%) as aortic valve replacement or a stentless valve (n=175, 62%) with inclusion/modified inclusion (n=117, 68%), or a total root replacement (n=55, 32%). Data was initially obtained from the STS database, then aided with chart review and national death index data.ResultsThe mean age of patients was similar in the stented and stentless groups (53 vs 57.5 years p=0.19). Compared to the stented group, the stentless group had significantly higher incidence of previous aortic valve (48 vs 17%) and root (8 vs 3%) procedure, prosthetic valve endocarditis (56 vs 20%), root abscess (59 vs 29%), root aneurysm (10 vs 1%), reoperation surgery (59 vs 24%), and circulatory arrest (8 vs 1%) (all p<0.05). The stentless group also had more concomitant ascending aorta procedure (22 vs 6%) and longer cardiopulmonary bypass time (247 vs 170 mins) and cross clamp time (200 vs 131 mins), all p<0.05. There were no significant differences in postoperative outcomes including stroke (1 vs 2%), new onset renal failure (3.7 vs 4.1%), or in-hospital mortality (5 vs 6%) between the stented and stentless group. The significant risk factors for operative mortality was liver disease with odds ratio (OR) of 5, p=0.01. The OR for stented vs stentless valve was 1, p=0.9. The 10-year survival was 19% vs 46% in stented valve and stentless valve group (p=0.01). The significant risk factor for late mortality was liver disease with hazard ratio (HR) of 4.9 and congestive heart failure (HR=1.5), all p<0.05. HR for stented vs stentless for late mortality was 1.14, p=0.58.ConclusionsBoth stented or stentless aortic valves are appropriate conduit for repair of active aortic valve endocarditis.