PMID- 19161769
OWN - NLM
STAT- MEDLINE
DCOM- 20090211
LR  - 20221207
IS  - 1552-6259 (Electronic)
IS  - 0003-4975 (Linking)
VI  - 87
IP  - 2
DP  - 2009 Feb
TI  - Aortic root replacement with stentless porcine xenografts: early and late 
      outcomes in 132 patients.
PG  - 503-12; discussion 512-3
LID - 10.1016/j.athoracsur.2008.11.033 [doi]
AB  - 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.
FAU - LeMaire, Scott A
AU  - LeMaire SA
AD  - 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, USA. slemaire@bcm.edu.
FAU - Green, Susan Y
AU  - Green SY
FAU - Sharma, Kapil
AU  - Sharma K
FAU - Cheung, Catherine K
AU  - Cheung CK
FAU - Sameri, Aryan
AU  - Sameri A
FAU - Tsai, Peter I
AU  - Tsai PI
FAU - Adams, Gerald
AU  - Adams G
FAU - Coselli, Joseph S
AU  - Coselli JS
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PL  - Netherlands
TA  - Ann Thorac Surg
JT  - The Annals of thoracic surgery
JID - 15030100R
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Aortic Dissection/diagnostic imaging/mortality/*surgery
MH  - Animals
MH  - Aorta, Thoracic/*surgery
MH  - Aortic Aneurysm, Thoracic/diagnostic imaging/mortality/*surgery
MH  - Blood Vessel Prosthesis Implantation/adverse effects/*methods
MH  - Female
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Postoperative Complications/mortality
MH  - Probability
MH  - Prognosis
MH  - Prosthesis Design
MH  - Prosthesis Failure
MH  - Radiography
MH  - Reoperation
MH  - Risk Assessment
MH  - Survival Rate
MH  - Swine
MH  - Transplantation, Heterologous/*methods
MH  - Treatment Outcome
MH  - Young Adult
EDAT- 2009/01/24 09:00
MHDA- 2009/02/12 09:00
CRDT- 2009/01/24 09:00
PHST- 2007/12/31 00:00 [received]
PHST- 2008/11/08 00:00 [revised]
PHST- 2008/11/12 00:00 [accepted]
PHST- 2009/01/24 09:00 [entrez]
PHST- 2009/01/24 09:00 [pubmed]
PHST- 2009/02/12 09:00 [medline]
AID - S0003-4975(08)02464-8 [pii]
AID - 10.1016/j.athoracsur.2008.11.033 [doi]
PST - ppublish
SO  - Ann Thorac Surg. 2009 Feb;87(2):503-12; discussion 512-3. doi: 
      10.1016/j.athoracsur.2008.11.033.