HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Scott A. LeMaire Kapil Sharma Joseph S. Coselli Permission Requests Citing Articles Citing Articles via Google Scholar Google Scholar Articles by LeMaire, S. A. Articles by Coselli, J. S. Search for Related Content PubMed Articles by LeMaire, S. A. Articles by Coselli, J. S. Related Collections Great vessels

---

Original Articles: Adult Cardiac

Aortic Root Replacement With Stentless Porcine Xenografts: Early and Late Outcomes in 132 Patients

The Texas Heart Institute at St. Luke's Episcopal Hospital, and the Division of Cardiothoracic Surgery, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, Texas

Accepted for publication November 12, 2008.

^_* Address correspondence to Dr LeMaire, One Baylor Plaza, BCM 390, Houston, TX 77030 (Email: slemaire{at}bcm.edu).

Presented at the Fifty-fourth Annual Meeting of the Southern Thoracic Surgical Association, Bonita Springs, FL, Nov 7–10, 2007.

Background: Traditionally, aortic root replacement has most commonly involved mechanical composite valve grafts, which have excellent durability but necessitate lifelong anticoagulation. Stentless porcine xenografts (bioroots) are a recently developed alternative that enable root replacement without the necessity of long-term anticoagulation. This study examined the early and late outcomes of aortic root replacement with porcine bioroots.

Methods: Porcine bioroots were used for root replacement in 132 patients. Of these, 129 (97.7%) required graft extensions for ascending aortic replacement, and 55 (41.7%) underwent aortic arch replacement. Twenty-three operations (17.4%) were reoperations. Twenty-four patients (18.2%) had aortic dissection. Early and late outcomes were ascertained by reviewing medical records. Changes in New York Heart Association (NYHA) class were used to assess improvements in functional status. Follow-up echocardiography results were reviewed to assess bioprosthetic valve function and changes in left ventricular ejection fraction.

Results: There were 10 operative deaths (7.6%), 9 of which were directly related to intraoperative ventricular failure. Nine patients (6.8%) had late valve-related complications, including 5 patients with prosthetic endocarditis (3 died), 1 annular pseudoaneurysm, and 3 sudden, unexplained deaths. Survivors' NYHA status and left ventricular ejection fraction improved significantly. No structural valve dysfunction was evident during follow-up. Actuarial survival was 85.6% ± 3.1% at 1 year and 77.8% ± 4.8% at 5 years.

Conclusions: Aortic root replacement with porcine xenografts can be performed with respectable early and late outcomes, even when combined with aortic arch replacement. Further follow-up is necessary to evaluate long-term bioroot durability.