title: Stentless biological valved conduit for aortic root replacement: initial experience with the Shelhigh BioConduit model NR-2000C.
abstract: OBJECTIVE
  We retrospectively evaluated our results with the Shelhigh biological conduit model NR-2000C (Shelhigh, Inc, Milburn, NJ).
  
  
  METHODS
  From November 1998 through December 2007, 175 patients with a mean age of 71.1 ± 7.4 years underwent aortic root replacement with a Shelhigh biological conduit. Indication for surgery was aneurysmal disease of the aorta in 120 (68.6%) patients, aortic valve endocarditis in 20 (11.4%), acute type A aortic dissection in 11 (6.3%), and other in 24 (13.7%) patients.
  
  
  RESULTS
  Overall hospital mortality was 13.7% (n = 24; 95% confidence limits, 9.0%-19.7%). Cause of death was cardiac failure in 12 patients, central neurologic damage in 5 patients, pulmonary in 3 patients, gastrointestinal ischemia in 2 patients, and aorta-related in 2 patients. Mean follow-up was 3.1 years (range 0.2-9.9 years). In total, 50 (33.1%) late deaths occurred; of these 7 were valve-related. The overall survival at 1 and 5 years is 77.6% ± 3.2% and 54.6% ± 4.6% respectively. Six (4.0%) patients required reoperation, either for endocarditis of the bioconduit (n = 5) or for false aneurysm (n = 1). Endocarditis of the bioconduit was reported in 11 (7.3%) patients, of whom 6 were treated nonoperatively and 5 required reoperation.
  
  
  CONCLUSIONS
  Midterm results of the implantation of the Shelhigh biological valved conduit are worrisome. The relatively high incidence of endocarditis of the Shelhigh BioConduit has forced us to look for other alternatives.
authors.affiliation: Department of Cardiothoracic Surgery, St Antonius Hospital, Nieuwegein, The Netherlands. a_kaya33@hotmail.com
authors.forename: Abdullah
authors.initials: A
authors.lastname: Kaya
authors.forename: Robin H
authors.initials: RH
authors.lastname: Heijmen
authors.forename: J C
authors.initials: JC
authors.lastname: Kelder
authors.forename: Marc A
authors.initials: MA
authors.lastname: Schepens
authors.forename: Wim J
authors.initials: WJ
authors.lastname: Morshuis
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017541:Aneurysm, False / Q000209:etiology / Q000601:surgery; D001018:Aortic Diseases / Q000401:mortality / Q000601:surgery*; D001021:Aortic Valve / Q000601:surgery*; D001705:Bioprosthesis; D001807:Blood Vessel Prosthesis / Q000009:adverse effects; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects / Q000295:instrumentation* / Q000401:mortality; D004696:Endocarditis / Q000401:mortality / Q000601:surgery*; D005260:Female; D006350:Heart Valve Prosthesis / Q000009:adverse effects; D019918:Heart Valve Prosthesis Implantation / Q000009:adverse effects / Q000295:instrumentation* / Q000401:mortality; D017052:Hospital Mortality; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D011474:Prosthesis Design; D016459:Prosthesis-Related Infections / Q000209:etiology / Q000601:surgery; D012086:Reoperation; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D015996:Survival Rate; D013997:Time Factors; D016896:Treatment Outcome