PMID- 25732971
OWN - NLM
STAT- MEDLINE
DCOM- 20160919
LR  - 20191210
IS  - 1873-734X (Electronic)
IS  - 1010-7940 (Linking)
VI  - 49
IP  - 1
DP  - 2016 Jan
TI  - Surgical management of destructive aortic endocarditis: left ventricular outflow 
      reconstruction with the Sorin Pericarbon Freedom stentless bioprosthesisdagger.
PG  - 242-8
LID - 10.1093/ejcts/ezv068 [doi]
AB  - OBJECTIVES: The treatment of complicated aortic endocarditis with periannular 
      abscesses and root disarrangement is a surgical challenge, and includes left 
      ventricular outflow tract (LVOT) reconstruction with the patch technique or 
      homograft implantation. The results of a simplified technique to reconstruct the 
      LVOT in destructive endocarditis of either the aortic native valve or valve 
      prosthesis with the Sorin Pericarbon Freedom stentless valve are reported. 
      METHODS: Since August 2007, 40 patients with destructive endocarditis (mean age: 
      69 +/- 12, 75% males, European System for Cardiac Operative Risk Evaluation II 
      (EuroSCORE II): 19 +/- 13, New York Heart Association (NYHA) class: >/=3 in all 
      cases) have undergone LVOT reconstruction with a Sorin Pericarbon Freedom 
      stentless bioprosthesis. Seven patients (17.5%) were in septic or cardiogenic 
      shock preoperatively, and 18 patients (45%) suffered from moderate or severe 
      aortic regurgitation. Eleven patients (27.5%) experienced preoperative systemic 
      embolizations. Thirty-six cases (90%) were valve redos and 9 patients (22.5%) had 
      concomitant procedures. The mean follow-up was 26 +/- 25 months. RESULTS: One 
      patient (2.5%) died early (<30 days) and another 3 patients never discharged died 
      due to multiorgan failure and septic shock. Actuarial survival rate was 85 +/- 6% 
      at 1 year, and 76 +/- 8% at 3 and 5 years, respectively. Twelve patients (30%) 
      required pacemaker implantation because of atrioventricular block and 20 patients 
      (50%) developed or showed a progression of renal failure. One patient (2.5%) had 
      an endocarditis relapse, and 1 (2.5%) showed a mild paraprosthetic aortic leak. 
      No patient needed reoperation. At the last echocardiographic evaluation, mean 
      gradient, peak gradient and left ventricular ejection fraction were 7.9 +/- 5.0 
      mmHg, 15.1 +/- 7.2 mmHg and 63.3 +/- 9.3%, respectively. CONCLUSIONS: The Sorin 
      Pericarbon Freedom stentless prosthesis, with the modified technique herein 
      described, seems to be a good option in most of cases of destructive aortic valve 
      endocarditis. It is promptly available in different sizes, easy to implant and, 
      due to its pericardial inflow skirt, ideal for extensive reconstruction of the 
      LVOT with good haemodynamic performance and low risk of relapse.
CI  - (c) The Author 2015. Published by Oxford University Press on behalf of the European 
      Association for Cardio-Thoracic Surgery. All rights reserved.
FAU - Sponga, Sandro
AU  - Sponga S
AD  - Cardiothoracic Department, University Hospital of Udine, Udine, Italy 
      sandro_sponga@yahoo.com.
FAU - Daffarra, Cristian
AU  - Daffarra C
AD  - Cardiothoracic Department, University Hospital of Udine, Udine, Italy.
FAU - Pavoni, Daisy
AU  - Pavoni D
AD  - Cardiothoracic Department, University Hospital of Udine, Udine, Italy.
FAU - Vendramin, Igor
AU  - Vendramin I
AD  - Cardiothoracic Department, University Hospital of Udine, Udine, Italy.
FAU - Mazzaro, Enzo
AU  - Mazzaro E
AD  - Cardiothoracic Department, University Hospital of Udine, Udine, Italy.
FAU - Piani, Daniela
AU  - Piani D
AD  - Cardiothoracic Department, University Hospital of Udine, Udine, Italy.
FAU - Nalli, Chiara
AU  - Nalli C
AD  - Cardiothoracic Department, University Hospital of Udine, Udine, Italy.
FAU - Nucifora, Gaetano
AU  - Nucifora G
AD  - Cardiothoracic Department, University Hospital of Udine, Udine, Italy.
FAU - Livi, Ugolino
AU  - Livi U
AD  - Cardiothoracic Department, University Hospital of Udine, Udine, Italy.
LA  - eng
PT  - Evaluation Study
PT  - Journal Article
DEP - 20150301
PL  - Germany
TA  - Eur J Cardiothorac Surg
JT  - European journal of cardio-thoracic surgery : official journal of the European 
      Association for Cardio-thoracic Surgery
JID - 8804069
SB  - IM
MH  - Aged
MH  - Aged, 80 and over
MH  - Aortic Valve/diagnostic imaging/*surgery
MH  - *Bioprosthesis
MH  - Echocardiography, Transesophageal
MH  - Endocarditis, Bacterial/diagnostic imaging/*surgery
MH  - Female
MH  - Follow-Up Studies
MH  - Heart Valve Diseases/diagnostic imaging/*surgery
MH  - *Heart Valve Prosthesis
MH  - Heart Valve Prosthesis Implantation/adverse effects/*methods
MH  - Heart Ventricles/diagnostic imaging/surgery
MH  - Humans
MH  - Kaplan-Meier Estimate
MH  - Male
MH  - Middle Aged
MH  - Prosthesis Design
MH  - Stents
MH  - Treatment Outcome
OTO - NOTNLM
OT  - Endocarditis
OT  - Pericarbon Freedom
OT  - Stentless valve
EDAT- 2015/03/04 06:00
MHDA- 2016/09/20 06:00
CRDT- 2015/03/04 06:00
PHST- 2014/09/14 00:00 [received]
PHST- 2015/01/02 00:00 [accepted]
PHST- 2015/03/04 06:00 [entrez]
PHST- 2015/03/04 06:00 [pubmed]
PHST- 2016/09/20 06:00 [medline]
AID - ezv068 [pii]
AID - 10.1093/ejcts/ezv068 [doi]
PST - ppublish
SO  - Eur J Cardiothorac Surg. 2016 Jan;49(1):242-8. doi: 10.1093/ejcts/ezv068. Epub 
      2015 Mar 1.