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

This Article Abstract 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 Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Tuna, I. C. Articles by Danielson, G. K. Search for Related Content PubMed PubMed Citation Articles by Tuna, I. C. Articles by Danielson, G. K.

Ann Thorac Surg 1990;49:619-624
© 1990 The Society of Thoracic Surgeons

---

Articles

Results of homograft aortic valve replacement for active endocarditis

Section of Cardiovascular Surgery, Mayo Clinic and Mayo Foundation, Rochester, Minnesota USA

^_* Address reprint requests to Dr Orszulak, Mayo Clinic, 200 First St SW, Rochester, MN 55905.

	Abstract

Top Abstract Footnotes References

 
Since July 1985, cryopreserved homograft prostheses have been used for aortic valve replacement in 10 patients, aged 2 to 77 years, with active endocarditis. Five patients had positive bacterial cultures from excised valves, and all had clinical findings of uncontrolled infection while receiving appropriate antibiotics. Homograft valves (four) or valved conduits (six) were implanted for treatment of sepsis (6 patients), congestive heart failure (3) or recurrent emboli (1 patient), and complicating native (5 patients) or prosthetic valve (5) endocarditis. Staphylococci (6 patients), streptococci (3), and Candida (1) were infecting organisms. Preoperatively, Doppler echocardiography showed aortic regurgitation in all patients. At operation, 9 patients had gross vegetations, 9 had single or multiple abscess cavities. and 5 had pericarditis. Complex reconstruction of the aortic valve and annulus with homograft conduits was necessary in 6 patients (3 with previous aortoventriculoplasty). Two early deaths (ventricular failure, perioperative stroke) occurred. Mean follow-up of all operative survivors was 2.1 years (range, 0.6 to 3.6 years), and one late death resulted from arrhythmia. Homograft valve regurgitation increased in 1 patient, and 7 late survivors are asymptomatic. No patient has had recurrence of endocarditis. We conclude that cryopreserved homograft aortic valve/root replacement is an effective method for management of active endocarditis complicated by annular destruction.

	Footnotes

Top Abstract Footnotes References

 
Presented at the Thirty-sixth Annual Meeting of the Southern Thoracic Surgical Association, Scottsdale, AZ, Nov 9–11, 1989.

	References

Top Abstract Footnotes References

 

1. Kirklin JK, Kirklin JW, Pacifico AD. Aortic valve endocarditis with aortic root abscess cavity: surgical treatment with aortic valve homograft Ann Thorac Surg 1988;45:674-677.[Abstract/Free Full Text]
2. Donaldson RM, Ross DM. Homograft aortic root replacement for complicated prosthetic valve endocarditis Circulation 1984;70(Suppl 1):178.[Abstract/Free Full Text]
3. Reitz BA, Stinson EB, Watson DC, Baumgartner WA, Jamieson SW. Translocation of the aortic valve for prosthetic valve endocarditis J Thorac Cardiovasc Surg 1981;81:212-218.[Abstract]
4. Frantz PT, Murrary GF, Wilcox BR. Surgical management of left ventricular-aortic discontinuity complicating bacterial endocarditis Ann Thorac Sarg 1980;29:1-7.
5. Zwischenberger JB, Shalaby TZ, Conti VR. Viable cryopreserved aortic homograft for aortic valve endocarditis and annular abscesses Ann Thorac Surg 1989;48:365-370.[Abstract/Free Full Text]
6. Danielson GK, Titus JL, DuShane JW. Successful treatment of aortic valve endocarditis and aortic root abscesses by insertion of prosthetic valve in ascending aorta and placement of bypass grafts to coronary arteries J Thorac Cardiovasc Surg 1974;67:443-449.[Medline]
7. Lau JKH, Robles A, Cherian A, Ross DN. Surgical treatment of prosthetic endocarditis J Thorac Cardiovasc Surg 1984;87:712-716.[Abstract]
8. Bove EL, Parker Jr FB, Marvasti MA, Randall PA. Complete extra-anatomic bypass of the aortic root: treatment of recurrent mediastinal infection J Thorac Cardiovasc Surg 1983;86:932-934.[Abstract]
9. VanHooser DW, Johnson RG, Hein RA, Elkins RC. Successful management of aortic valve endocarditis with associated periannular abscess and aneurysm Ann Thorac Surg 1986;42:148-151.[Abstract/Free Full Text]
10. Bailey WW, Ivey TD, Miller Jr DW. Dacron patch closure of aortic annulus mycotic aneurysms Circulation 1982;66(Suppl 1):127-130.
11. Endo M, Nishida H, Imamura E, Koyanagi H. Sutureless aortic valve replacement for periannular abscess due to active bacterial endocarditis: a new translocation technique Ann Thorac Surg 1988;45:568-569.[Abstract/Free Full Text]
12. Symbas PN, Vlasis SE, Zacharopoulos L, Lutz JF. Acute endocarditis: surgical treatment of aortic regurgitation and aortico-left ventricular discontinuity J Thorac Cardiovasc Surg 1982;84:291-296.[Abstract]
13. Frantz PT, Murray GF, Wilcox BR. Surgical management of left ventricular-aortic discontinuity complicating bacterial endocarditis Ann Thorac Surg 1980;29:1-7.[Abstract/Free Full Text]
14. David TE, Komeda M, Brofman PR. Surgical treatment of aortic root abscess Circulation 1989;80(Suppl 1):269-274.
15. Konno S, Imai Y, Iida Y, Nakajima M, Tatsuno K. A new method for prosthetic valve replacement in congenital aortic stenosis associated with hypoplasia of the aortic valve ring J Thorac Cardiovasc Surg 1975;70:909-917.[Abstract]
16. Rastan H, Koncz J. Aortoventriculoplasty: a new technique for the treatment of left ventricular outflow tract obstruction J Thorac Cardiovasc Surg 1976;71:920-927.[Abstract]
17. Wilson WR, Danielson GK, Giuliani ER, Geraci JE. Prosthetic valve endocarditis11th ed. Mayo Clin Proc. 57. 1982. pp. 155-161.
18. Croft CH, Woodward W, Elliott A, Commerford PJ, Barnard CN, Beck W. Analysis of surgical versus medical therapy in active complicated native valve infective endocarditis Am J Cardiol 1983;51:1650-1655.[Medline]
19. Arnett EN, Roberts WC. Valve ring abscess in active infective endocarditis Circulation 1976;54:140-145.[Abstract/Free Full Text]
20. Okita Y, Franciosi G, Matsuki O, Robles A, Ross DN. Early and late results of aortic root replacement With antibioticsterilized aortic homograft J Thorac Cardiovasc Surg 1988;95:696-704.[Abstract]
21. Kirklin JW, Barratt-Boyes BG. Aortic valve diseaseIn: Kirklin JW, Barratt-Boyes BG, editors. Cardiac surgery. New York: John Wiley; 1986. pp. 373-429.
22. Matsuki O, Robles A, Gibbs S, Bodnar E, Ross DN. Longterm performance of 555 aortic homografts in the aortic position Ann Thorac Surg 1988;46:187-191.[Abstract/Free Full Text]
23. O'Brien MF, McGiffin DC, Stafford EG. Allograft aortic valve implantation: techniques for all types of aortic valve and root pathology Ann Thorac Surg 1989;48:600-609.[Abstract/Free Full Text]
24. Matsuki O, Okita Y, Almeida RS, et al. Two decades' experience with aortic valve replacement with pulmonary autograft J Thorac Cardiovasc Surg 1988;95:705-711.[Abstract]

This article has been cited by other articles:

				K. G. M. Brockbank, G. J. Wright, H. Yao, E. D. Greene, Z. Z. Chen, and K. Schenke-Layland Allogeneic Heart Valve Storage Above the Glass Transition at -80{degrees}C Ann. Thorac. Surg., June 1, 2011; 91(6): 1829 - 1835. [Abstract] [Full Text] [PDF]

				D. T. Nguyen, F. Delahaye, J.-F. Obadia, X. Duval, C. Selton-Suty, J.-P. Carteaux, B. Hoen, F. Alla, and for the AEPEI study group Aortic valve replacement for active infective endocarditis: 5-year survival comparison of bioprostheses, homografts and mechanical prostheses Eur J Cardiothorac Surg, May 1, 2010; 37(5): 1025 - 1032. [Abstract] [Full Text] [PDF]

				A. J. Morris, D. Drinkovic, S. Pottumarthy, D. MacCulloch, A. R. Kerr, and T. West Bacteriological Outcome after Valve Surgery for Active Infective Endocarditis: Implications for Duration of Treatment after Surgery Clinical Infectious Diseases, July 15, 2005; 41(2): 187 - 194. [Abstract] [Full Text] [PDF]

				J.-M. Grinda, J.-L. Mainardi, N. D'Attellis, M.-O. Bricourt, A. Berrebi, J.-N. Fabiani, and A. Deloche Cryopreserved Aortic Viable Homograft for Active Aortic Endocarditis Ann. Thorac. Surg., March 1, 2005; 79(3): 767 - 771. [Abstract] [Full Text] [PDF]

				A. J. Morris, D. Drinkovic, S. Pottumarthy, M. G. Strickett, D. MacCulloch, N. Lambie, and A. R. Kerr Gram Stain, Culture, and Histopathological Examination Findings for Heart Valves Removed because of Infective Endocarditis Clinical Infectious Diseases, March 15, 2003; 36(6): 697 - 704. [Abstract] [Full Text] [PDF]

				N R A Clarke and J C Forfar Aortic root abscess presenting as unstable angina due to extrinsic compression of the left coronary artery Postgrad. Med. J., March 1, 2002; 78(917): 168 - 169. [Abstract] [Full Text] [PDF]

				C. J. Knott-Craig, R. C. Elkins, K. Santangelo, C. McCue, and M. M. Lane Aortic valve replacement: comparison of late survival between autografts and homografts Ann. Thorac. Surg., May 1, 2000; 69(5): 1327 - 1331. [Abstract] [Full Text] [PDF]

				R. Jashari, B. Van Hoeck, M. Gaudino, W. Daenen, T. Van Geldorp, P. Kalmar, and Y. Goffin Are pulmonary homografts which were subjected to pulmonary hypertension more appropriate for aortic valve replacement than normal pulmonary homografts? A long-term multicentric echography study Eur J Cardiothorac Surg, February 1, 2000; 17(2): 140 - 145. [Abstract] [Full Text] [PDF]

				R. Choussat, D. Thomas, R. Isnard, P.-L. Michel, B. Iung, G. Hanania, P. Mathieu, M. David, T. du Roy de Chaumaray, G. De Gevigney, et al. Perivalvular abscesses associated with endocarditis: Clinical features and prognostic factors of overall survival in a series of 233 cases Eur. Heart J., February 1, 1999; 20(3): 232 - 241. [Abstract] [PDF]

				R Chaturvedi, M de Leval, and I D Sullivan Urgent homograft aortic root replacement for aortic root abscess in infants and children Heart, January 1, 1999; 81(1): 62 - 66. [Abstract] [Full Text]

				G. Pettersson, J. Tingleff, and F. S. Joyce Treatment of aortic valve endocarditis with the Ross operation Eur J Cardiothorac Surg, June 1, 1998; 13(6): 678 - 684. [Abstract] [Full Text] [PDF]

				R. N. Mitchell, R. A. Jonas, and F. J. Schoen Pathology Of Explanted Cryopreserved Allograft Heart Valves: Comparison With Aortic Valves From Orthotopic Heart Transplants J. Thorac. Cardiovasc. Surg., January 1, 1998; 115(1): 118 - 127. [Abstract] [Full Text] [PDF]

				J. A. Dearani, T. A. Orszulak, H. V. Schaff, R. C. Daly, B. J. Anderson, and G. K. Danielson RESULTS OF ALLOGRAFT AORTIC VALVE REPLACEMENT FOR COMPLEX ENDOCARDITIS J. Thorac. Cardiovasc. Surg., February 1, 1997; 113(2): 285 - 291. [Abstract] [Full Text]

				J. A. Dearani, T. A. Orszulak, R. C. Daly, M. R. Phillips, F. A. Miller, G. K. Danielson, and H. V. Schaff Comparison of Techniques for Implantation of Aortic Valve Allografts Ann. Thorac. Surg., October 1, 1996; 62(4): 1069 - 1075. [Abstract] [Full Text]

				S. F. Aranki, D. H. Adams, R. J. Rizzo, G. S. Couper, T. E. Sullivan, J. J. Collins Jr, and L. H. Cohn Determinants of Early Mortality and Late Survival in Mitral Valve Endocarditis Circulation, November 1, 1995; 92(9): 143 - 149. [Abstract] [Full Text]

				A. S. Kumar, P. N. Rao, R. Sharma, A. Bhan, B. Airan, B. Das, K. S. Iyer, H. Trehan, and P. Venugopal Homograft Aortic Root Replacement for Early Prosthetic Endocarditis Asian Cardiovascular and Thoracic Annals, September 1, 1995; 3(3-4): 109 - 111. [Abstract] [Full Text] [PDF]

				M. O. P. Vrandecic, F. A. Fantini, B. F. Gontijo, O. C. Oliveira, I. C. J. Martins, M. H. C. Oliveira, S. O. S. Avelar, E. Vrandecic, and E. Vrandecic Surgical technique of implanting the stentless porcine mitral valve Ann. Thorac. Surg., August 1, 1995; 60(suppl_2): S439 - S442. [Abstract] [PDF]

				M. Sadiq, N. Sreeram, J. V. de Giovanni, J. G. Wright, W. J. Brawn, E. J. Ladusans, and B. Sethia Endocarditis with multiple intracardiac shunts: Identification and repair Ann. Thorac. Surg., March 1, 1995; 59(3): 753 - 755. [Abstract] [PDF]

				C. J. Knott-Craig, R. C. Elkins, P. L. Stelzer, J. D. Randolph, C. McCue, P. A. Wright, and M. M. Lane Homograft replacement of the aortic valve and root as a functional unit Ann. Thorac. Surg., June 1, 1994; 57(6): 1501 - 1506. [Abstract] [PDF]

				C. Minale, F. H. Splittgerber, and B. Cramer Cryopreserved pulmonary homograft for Bentall replacement of aortic root in a case of purulent bacterial endocarditis J. Thorac. Cardiovasc. Surg., June 1, 1994; 107(6): 1540 - 1541. [Full Text]

				G. Watanabe, A. Haverich, R. Speier, C. Dresler, and H. G. Borst Surgical treatment of active infective endocarditis with paravalvular involvement J. Thorac. Cardiovasc. Surg., January 1, 1994; 107(1): 171 - 177. [Abstract] [Full Text]

				M. J. Antunes Techniques of valvular reoperation Eur J Cardiothorac Surg, January 1, 1992; 6(Supplement_1): S54 - S58. [Abstract] [PDF]

This Article Abstract 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 Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Tuna, I. C. Articles by Danielson, G. K. Search for Related Content PubMed PubMed Citation Articles by Tuna, I. C. Articles by Danielson, G. K.