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Original Articles: Adult Cardiac

First 102 Patients With the Biovalsalva Conduit for Aortic Root Replacement

^a Department of Cardiothoracic Surgery, St. Antonius Hospital, Nieuwegein, the Netherlands
^b Department of Cardiology Research and Statistical Analysis, St. Antonius Hospital, Nieuwegein, the Netherlands

Accepted for publication March 19, 2012.

^_* Address correspondence to Dr Kaya, Department of Cardiothoracic Surgery, St. Antonius Hospital, Koekoekslaan 1, 3435 CM Nieuwegein, The Netherlands (Email: a_kaya33{at}hotmail.com).

Background: We retrospectively evaluated our results with the BioValsalva Conduit (Vascutek Terumo, Renfrewshire Scotland), a stentless porcine valve incorporated in a 3-layered prosthetic graft.

Methods: From July 2008 through April 2011, 102 patients with a mean age of 70.9 ± 7.3 years underwent aortic root replacement with a BioValsalva conduit. The indication for surgery was aneurysmal disease of the aorta in 81 patients (79.4%), aortic valve endocarditis in 15 patients (14.7%), acute type A aortic dissection in 4 patients (3.9%), and other causes in 2 patients (2.0%). In 26 patients (25.5%), the intervention was a reoperation.

Results: Overall hospital mortality was 4.9% (n = 5; 95% confidence limit [CL], 1.6%–11.1%). Cause of death was cardiac failure in 2 patients, multiple organ or renal failure in 2 patients, and tamponade in 1 patient. Mean follow-up was 8.1 months. During follow-up, 3 deaths occurred (3.1%) because of mediastinitis, cardiac ischemia, and arrhythmia. The overall survival at 3 and 12 months was 95.9% (95% CL, 92.0% –99.9%) and 92.1% (95% CL, 85.7% –98.9%) respectively. Three patients (3.1%) had new-onset endocarditis of the BioValsalva conduit; 2 of these patients required reoperation and 1 patient received antibiotic treatment only.

Conclusions: Retrospective analysis of the BioValsalva conduit for aortic root replacement in more than 100 consecutive patients demonstrated satisfactory initial results, with low mortality and acceptable low morbidity rates. Follow-up is mandatory and long-term results are to be awaited.