Survival after aortic root replacement with a stentless xenograft is determined by patient characteristics.
J Thorac Cardiovasc Surg
; 164(6): 1712-1724.e10, 2022 12.
Article
en En
| MEDLINE
| ID: mdl-34452760
ABSTRACT
OBJECTIVES:
Our objective was to examine intermediate-term survival and reinterventions in unselected patients, stratified according to indication, who received a Freestyle (Medtronic Inc, Minneapolis, Minn) bioprosthesis as a full aortic root replacement.METHODS:
Data from medical records were retrospectively collected for patients who had aortic root replacement using Freestyle bioprostheses between 1999 and 2018 at 6 North-Atlantic centers. Survival status was extracted from national registries and results stratified according to indication for surgery.RESULTS:
We included 1030 implantations in 1008 patients with elective indications for surgery aneurysm (39.8%), small root (8.3%), and other (13.8%), and urgent/emergent indications endocarditis (26.7%) and Stanford type A aortic dissection (11.4%). Across indications, 46.3% were nonelective cases and 34.0% were reoperations. Median age was 66.0 (interquartile range, 58.0-71.8) years and median follow-up was 5.0 (interquartile range, 2.6-7.9) years. Thirty-day mortality varied from 2.9% to 27.4% depending on indication. Intermediate survival for 90-day survivors with elective indications were not different from the general population standardized for age and sex (P = .95, .83, and .16 for aneurysms, small roots, and other, respectively). In contrast, patients with endocarditis and type A dissection had excess mortality (P < .001). Freedom from valve reinterventions was 95.0% and 94.4% at 5 and 8 years, respectively. In all, 52 patients (5.2%) underwent reinterventions, most because of endocarditis.CONCLUSIONS:
At intermediate term follow-up this retrospective study provides further support for the use of the Freestyle bioprosthesis in the real-world setting of diverse, complex, and often high-risk aortic root replacement and suggests that outcome is determined by patient and disease, rather than by prosthesis, characteristics.Palabras clave
Texto completo:
1
Colección:
01-internacional
Banco de datos:
MEDLINE
Asunto principal:
Bioprótesis
/
Prótesis Valvulares Cardíacas
/
Implantación de Prótesis de Válvulas Cardíacas
/
Endocarditis
Tipo de estudio:
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Límite:
Aged
/
Humans
Idioma:
En
Revista:
J Thorac Cardiovasc Surg
Año:
2022
Tipo del documento:
Article