Early experience with a prefabricated bioprosthetic aortic valved conduit: The first 100

预制生物瓣膜主动脉导管的早期应用经验:前100例

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Abstract

OBJECTIVE: To evaluate the early postoperative morbidity, mortality, and prosthetic conduit function of patients who underwent aortic root replacement using a prefabricated bioprosthetic aortic valved conduit. METHODS: Single-center retrospective review of 124 consecutive adult patients who underwent aortic root replacement with a certified prefabricated bioprosthetic aortic valved conduit from 2021 to December 2023. RESULTS: Indications for operation were aortic aneurysms (n = 92), endocarditis (n = 12), deterioration of prior valve prosthesis (n = 13), and aortic dissection (n = 6). Implanted valve sizes were 29 mm (n = 37), 27 mm (n = 41), 25 mm (n = 31), 23 mm (n = 14), and 21 mm (n = 1). Isolated aortic root repair was performed in 48 patients, concomitant hemiarch in 69 patients and total arch in 7 patients. Thirty-day mortality rate was 5% (n = 6), permanent pacemaker implantation was necessary in 14% (n = 17), reoperation for bleeding in 4% (n = 5), and only 1 patient developed postoperative stroke. Discharge echocardiogram was available in 118 patients, and follow-up assessment in 45 patients. Prosthetic aortic valve gradient, effective orifice area, and Doppler velocity index remained within normal limits. CONCLUSIONS: The prefabricated bioprosthetic aortic valved conduit was used in all settings, including complex reoperations, acute dissection, and endocarditis with acceptable short-term morbidity and mortality. The hemodynamic performance of the valve within the studied period was normal, the long-term durability and hemodynamic performance are yet to be proven.

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