Aortic valve replacement with a stentless bioprosthesis using the full-root technique.
BACKGROUND
In aortic valve replacement stentless bioprostheses results in improved hemodynamic function compared to stented valves. Using the root replacement technique even larger prostheses are implantable. We present our experience with stentless bioprostheses implanted in the "full-root" technique.


METHODS
Between 01/1997 and 12/2000, 149 patients underwent root replacement with a stentless xenograft (age 70 +/- 9y, women 52 %, ejection-fraction 58 +/- 15 %). Isolated stenosis was present in 34 %, incompetence in 24 %, and mixed disease in 42 % of patients. Bacterial endocarditis was found in 16 %, and 3 patients suffered from acute aortic dissection.


RESULTS
Mean bypass time was 118 +/- 45 min, ischemic time 83 +/- 26 min and operating time 201 +/- 62 min. Concomitant procedures were CABG (32 %), replacement of ascending aorta (22 %) and aortic arch (13 %), mitral valve repair (6.7 %), and carotid thrombendarterectomy (1.3 %). Total in-hospital mortality was 6.7 %, with a 1.8 % mortality rate for patients with isolated aortic valve disease.


CONCLUSIONS
Aortic valve replacement using stentless bioprostheses in the root replacement technique is a safe surgical option. In patients with small aortic roots or ring abscesses it guarantees remodelling of the aortic annulus.
Wendler
O
O
Department of Thoracic and Cardiovascular Surgery, University Hospital Homburg/Saar, Kirrberger Strasse 1, 66421 Homburg/Saar, Germany. chowen@med-rrz.uni-sb.de
Dzindzibadze
V
V
Langer
F
F
El Dsoki
S
S
Schäfers
H J
HJ
D000368:Aged; D001021:Aortic Valve / Q000601:surgery*; D001024:Aortic Valve Stenosis / Q000150:complications / Q000401:mortality / Q000601:surgery; D001705:Bioprosthesis; D002303:Cardiac Output, Low / Q000150:complications; D003131:Combined Modality Therapy / Q000401:mortality; D001026:Coronary Artery Bypass / Q000401:mortality; D004867:Equipment Design; D005260:Female; D005858:Germany / Q000453:epidemiology; D019918:Heart Valve Prosthesis Implantation / Q000295:instrumentation* / Q000401:mortality; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000401:mortality / Q000601:surgery; D012086:Reoperation; D015607:Stents; D016019:Survival Analysis; D013577:Syndrome; D016896:Treatment Outcome