title: Aortic root replacement using a modified composite valve graft.
abstract: OBJECTIVE
  We used a modified technique of a composite graft by moving the valve prosthesis away from the end into the inside of the tube and compared the effectiveness of this surgical method with the standard valved conduits.
  
  
  METHODS
  Through a prospective nonrandomized clinical study between March 2011 and June 2012, we performed replacement of the aortic valve and ascending aorta in 30 consecutive patients using a valved composite graft with a mechanical valve prosthesis. A modified self-assembled valved composite graft was employed in 20 patients (Modified group), while the remaining 10 patients received the standard composite graft (Control group).
  
  
  RESULTS
  There was significantly less bleeding in the patients with modified grafts (184 vs. 415 mL, p < 0.05). Moreover, the mean transvalvular gradient of the composite graft patients was lower in the modified group than in the control group (9 vs. 14 mmHg, respectively, p < 0.05).
  
  
  CONCLUSIONS
  The modified valve composite graft technique results in good hemodynamics and appears to limit blood loss.
authors.affiliation: Department of Cardiology, Day General Hospital, Tehran, Iran.
authors.forename: Farideh
authors.initials: F
authors.lastname: Roshanali
authors.forename: Saeed
authors.initials: S
authors.lastname: Shoar
authors.forename: Nasrin
authors.initials: N
authors.lastname: Shoar
authors.forename: Mohammad
authors.initials: M
authors.lastname: Naderan
authors.forename: Mohammad Ali
authors.initials: MA
authors.lastname: Yousefnia
authors.forename: Mohammad Hossein
authors.initials: MH
authors.lastname: Mandegar
mesh_terms: D000368:Aged; D001011:Aorta / Q000601:surgery*; D001014:Aortic Aneurysm / Q000150:complications / Q000601:surgery; D001021:Aortic Valve / Q000601:surgery*; D000082882:Bicuspid Aortic Valve Disease; D016063:Blood Loss, Surgical / Q000517:prevention & control; D019917:Blood Vessel Prosthesis Implantation / Q000379:methods*; D002986:Clinical Trials as Topic; D005260:Female; D006330:Heart Defects, Congenital / Q000150:complications / Q000601:surgery; D006349:Heart Valve Diseases / Q000150:complications / Q000601:surgery; D006350:Heart Valve Prosthesis; D019918:Heart Valve Prosthesis Implantation / Q000379:methods*; D006439:Hemodynamics; D006801:Humans; D008297:Male; D008875:Middle Aged; D016896:Treatment Outcome