title: Long-term results of aortomitral fibrous body reconstruction with double-valve replacement.
abstract: BACKGROUND
  This study aims to evaluate the early and long-term outcome of aortomitral fibrous body reconstruction with bovine pericardium in double-valve replacement.
  
  
  METHODS
  Between January 1997 and December 2010, 30 consecutive patients (20 male patients) underwent aortomitral fibrous body reconstruction with double-valve replacement. Mean age was 52 ± 15 years (range, 9 to 77 years). The operative indications were infective endocarditis (IE) for 22 patients, small annuli for 5, and fragile annuli for 3. Bovine pericardium was used for all patients. Twelve patients (40%) needed an emergency operation for cardiogenic shock or septic emboli. The mean follow-up was 50.6 ± 43.5 months (range, 0 to 136 months).
  
  
  RESULTS
  There were 2 early (6.7%) and 5 late (16.7%) deaths. Early complications included bleeding in 6 patients, acute renal failure in 4, complete heart block in 3, and early reoperation due to paravalvular leakage in 1. Three patients with previous prosthetic valve endocarditis underwent late reoperations; specifically, redo valve replacements for 2 patients and heart transplantation for the other. Late dehiscence of prosthetic valve occurred in 1 patient with Behçet disease. In the IE patients, freedom from reoperation rate at 1 and 5 years was 95.5% and 84.8%, respectively, and the freedom from IE rate at 1 and 5 years was 94.7%. There was no statistical difference in overall survival rates between the patients with and without IE (p = 0.766).
  
  
  CONCLUSIONS
  The early and long-term results of aortomitral fibrous body reconstruction with double-valve replacement are promising, and bovine pericardium appears to have strong durability.
authors.affiliation: Department of Thoracic and Cardiovascular Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
authors.forename: Su Wan
authors.initials: SW
authors.lastname: Kim
authors.forename: Pyo Won
authors.initials: PW
authors.lastname: Park
authors.forename: Wook Sung
authors.initials: WS
authors.lastname: Kim
authors.forename: Kiick
authors.initials: K
authors.lastname: Sung
authors.forename: Young Tak
authors.initials: YT
authors.lastname: Lee
authors.forename: Tae-Gook
authors.initials: TG
authors.lastname: Jun
authors.forename: Dong Seop
authors.initials: DS
authors.lastname: Jeong
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001021:Aortic Valve / Q000601:surgery*; D001705:Bioprosthesis; D002648:Child; D004697:Endocarditis, Bacterial / Q000601:surgery*; D005260:Female; D006349:Heart Valve Diseases / Q000601:surgery*; D006350:Heart Valve Prosthesis; D006801:Humans; D008297:Male; D008875:Middle Aged; D008943:Mitral Valve / Q000601:surgery*; D010496:Pericardium / Q000637:transplantation; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult