Midterm results aortic valve replacement with allograft
Authors:
A. Mokráček 1; J. Špatenka 2; H. Pospíšilová 1; M. Šulda 1; R. Tesařík 1; M. Vambera 1; Š. Šindelářová 1; F. Toušek 1; M. Šetina 3; J. Vojáček 4; V. Lánská 5; L. Pešl 1
Authors‘ workplace:
Kardiocentrum Nemocnice České Budějovice, a. s., ředitel MUDr. Ladislav Pešl
1; Transplantcentrum FN Motol Praha, přednosta MUDr. Jaroslav Špatenka, CSc.
2; Kardiochirurgické oddělení FN Motol, Praha, přednosta doc. MUDr. Marek Šetina, CSc.
3; Kardiochirurgická klinika Lékařské fakulty UK a FN Hradec Králové, přednosta doc. MUDr. Jan Harrer, CSc.
4; Oddělení lékařské statistiky IKEM Praha, vedoucí RNDr. Věra Lánská, CSc.
5
Published in:
Vnitř Lék 2009; 55(2): 91-96
Category:
Original Contributions
Overview
Introduction:
Aortic allograft implantation into the aortic position in adults is standard procedure with some controversary. The most popular indication is bacterial endocarditis. We would like to present our midterm results.
Results:
We implanted 61 allografts in 60 patients (between 10/2002 and 04/2008). Men were 46 (76.8%) and average age was 57 ± 10.76 year. 30 days mortality was 9 people (15.0%, all with bacterial endocarditis). Late mortality 1 man (1.6%). Follow up 1–66 months, average 39.18 SD ± 14.3 months, median 42 months.
Conclusion:
Implantation of aortic allograft into the aortic position is standard procedure with good midterm results. Relative high early mortality is dependent on preoperative status in patiens with acute bacterial endocarditis – all early death people were people with acute bacterial endocarditis and minimally one vital organ severe dysfunction.
Key words:
allograft – endocarditis – aortic valve
Sources
1. Heimbecker RO, Baird RJ, Lajos TZ et al. Homograft replacement of the human valve. A preliminary report. Can Med Assoc J 1962; 86: 805–809.
2. Ross DN. Homograft replacement of the aortic valve. Lancet 1962; 2: 487.
3. Barratt-Boyes BG. Homograft aortic valve replacement in aortic incompetence and stenosis. Thorax 1964; 19: 131–150.
4. Mokráček A, Špatenka J, Šulda M et al. Aortální alograft (homograft) v léčbě chlopenních srdečních vad dospělých s důrazem na léčbu infekční endokarditidy aortální chlopně. Vnitř Lék 2007; 53: 54–62.
5. Hopkins RA. Cardiac reconstructions with allograft tissues. Influence of implant technique on allograft durability. New York: Springer Science media 2005: 30–39.
6. Takkenberg JJ, Eijkemans MJ, van Herwerden LA et al. Prognosis after aortic root replacement with cryopreserved allografts in adults. Ann Thorac Surg 2003; 75: 1482–1489.
7. Schoen FJ. Approach to the analysis of cardiac valve prostheses as surgical or autopsy speciments. Cardiovasc Pathol 1995; 4: 241–255.
8. Lund O, Chandrasekaran V, Yacoub MH et al. Primary aortic valve replacement with allografts over twenty-five years: valve‑related and procedure‑related determinants of outcome. J Thorac Cardiovasc Surg 1999; 117: 77–90.
9. Jamieson WR, Burr LH, Anderson WN et al. Prosthesis‑related complications: first-year annual rates. J Heart Valve Dis 2002; 11: 758–763.
10. Blumberg EA, Karalis DA, Chandrasekaran K et al. Endocarditis‑associated paravalvular abscesses. Do clinical parameters predict the presence of abscess? Chest 1995; 107: 898–903.
11. Sabik JF, Lytle BW, Blackstone EH et al. Aortic root replacement with cryopreserved allograft for prosthetic valve endocarditis. Ann Thorac Surg 2002; 74: 650–659.
12. Leyh RG, Knobloch K, Hagl C et al. Replacement of the aortic root for acute prosthestic valve endocarditis: prosthetic composite versus aortic allograft root replacement. J Thorac Cardiovasc Surg 2004; 127: 1416–1420.
13. Hagl C, Galla JD, Spielvogel D et al. Replacing the ascending aorta and aortic valve for acute prosthetic valve endocarditis: is using of prosthetic material contraindicated? Ann Thorac Surg 2002; 74: S1781–S1785.
14. Beneš J, Gregor P, Mokráček A. Doporučení pro diagnostiku, léčbu a profylaxi infekční endokarditidy. Cor Vasa 2007; 49: 157–171.
Labels
Diabetology Endocrinology Internal medicineArticle was published in
Internal Medicine
2009 Issue 2
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