title: Bentall procedure using cryopreserved valved aortic homografts: mid- to long-term results.
abstract: The Bentall procedure is the standard operation for patients who have lesions of the ascending aorta associated with aortic valve disease. In many cases, however, mechanical prosthetic conduits are not suitable. There are few reports in the English-language medical literature concerning the mid- to long-term outcome of Bentall operations with cryopreserved homografts. Therefore, we reviewed our experience with this procedure and valved homografts. From January 1997 through December 2002, 21 patients underwent a Bentall operation with cryopreserved homografts at our institution. There were 14 males and 7 females; the mean age was 36 +/- 21 years (range, 15-74 years). Eleven patients had undergone previous aortic valve surgery. All patients had aortic dilatation or aneurysms involving the ascending aorta. Indications for surgery included aortic valve stenosis or insufficiency, and aortic valve endocarditis (native valve or prosthetic). One patient had Takayasu's arteritis and 3 had Marfan syndrome. There was 1 hospital death (due to sepsis), but no other major postoperative complications. The mean hospital stay was 14 +/- 7 days. Follow-up echocardiographic and computed tomographic scans were performed yearly. The mean follow-up was 34 months (6-72 months). Follow-up imaging revealed no calcifications or degenerative processes related to the homograft. Four patients had minimal valve regurgitation. Two patients died during follow-up. The 3-year actuarial survival rate was 85.7%. Our data suggest that the Bentall procedure with a valved homograft conduit is a safe procedure with excellent mid- to long-term results, comparable to results reported with aortic valve replacement with a homograft.
authors.affiliation: Department of Cardiovascular Surgery, University Hospital of Geneva, CH-1211 Geneva 14, Switzerland. jan.christenson@hcuge.ch
authors.forename: Jan T
authors.initials: JT
authors.lastname: Christenson
authors.forename: Jorge
authors.initials: J
authors.lastname: Sierra
authors.forename: Pedro T
authors.initials: PT
authors.lastname: Trindade
authors.forename: Didier
authors.initials: D
authors.lastname: Dominique
authors.forename: Afksendiyos
authors.initials: A
authors.lastname: Kalangos
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001011:Aorta / Q000601:surgery*; D001014:Aortic Aneurysm / Q000150:complications / Q000601:surgery*; D001021:Aortic Valve / Q000637:transplantation*; D019917:Blood Vessel Prosthesis Implantation / Q000379:methods*; D015925:Cryopreservation; D005260:Female; D005500:Follow-Up Studies; D006349:Heart Valve Diseases / Q000150:complications / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D016896:Treatment Outcome
references.citation: Tex Heart Inst J. 2000;27(4):366-8
references.pmid: 11198310
references.citation: Ann Thorac Surg. 1998 Jul;66(1):88-91
references.pmid: 9692444
references.citation: J Heart Valve Dis. 2001 Sep;10(5):650-5
references.pmid: 11603605
references.citation: Eur J Cardiothorac Surg. 2002 Feb;21(2):260-7
references.pmid: 11825733
references.citation: Ann Thorac Surg. 2002 Feb;73(2):438-43
references.pmid: 11845856
references.citation: Asian Cardiovasc Thorac Ann. 2002 Jun;10(2):97-100
references.pmid: 12079928
references.citation: Thorac Cardiovasc Surg. 1981 Aug;29(4):195-9
references.pmid: 6179184
references.citation: J Thorac Cardiovasc Surg. 1987 Mar;93(3):366-74
references.pmid: 3821146
references.citation: J Thorac Cardiovasc Surg. 1988 Apr;95(4):696-704
references.pmid: 3352305
references.citation: Thorac Cardiovasc Surg. 1991 Jun;39(3):117-22
references.pmid: 1882374
references.citation: Ann Thorac Surg. 1991 Sep;52(3):669-73; discussion 673-5
references.pmid: 1898171
references.citation: J Thorac Cardiovasc Surg. 1993 Jul;106(1):154-65; discussion 165-6
references.pmid: 8320994
references.citation: J Thorac Cardiovasc Surg. 1994 Jun;107(6):1540-1
references.pmid: 8196407
references.citation: J Thorac Cardiovasc Surg. 1995 Mar;109(3):536-44; discussion 544-5
references.pmid: 7877316
references.citation: J Thorac Cardiovasc Surg. 1995 Jul;110(1):186-93; discussion 193-4
references.pmid: 7609543
references.citation: Ann Thorac Surg. 1995 Aug;60(2 Suppl):S65-70
references.pmid: 7646213
references.citation: Eur J Cardiothorac Surg. 1995;9(9):531-3
references.pmid: 8800705
references.citation: Ann Thorac Surg. 1997 Sep;64(3):659-63; discussion 663-4
references.pmid: 9307453
references.citation: Tex Heart Inst J. 1998;25(1):68-71
references.pmid: 9566067
references.citation: Eur J Cardiothorac Surg. 2001 Oct;20(4):835-41
references.pmid: 11574234