Aortic allograft valve reoperation: surgical challenges and patient risks

The Annals of Thoracic Surgery
Edward R NowickiBruce W Lytle

Abstract

Aortic valve allograft reoperation is a challenge for the surgeon and a risk to the patient. We examined our experience to identify these challenges and risks. From April 1987 to January 2006, 130 patients underwent first-time allograft-related reoperations. Prior implant was subcoronary 32 (25%), inclusion-root 28 (22%), and root 70 (53%). Reoperative indications were technical failure 11 (8.4%), endocarditis 31 (24%), and structural valve deterioration 88 (68%). Reoperative technique was allograft repair 7 (5.4%), simple valve replacement 80 (62%), and root replacement 43 (33%). Median follow-up was 3.1 years. Surgical challenges: 10 adverse intraoperative events occurred (7.7%), 3 allograft specific, with rescue from all. Reoperative procedure was highly dependent on original implantation technique (31 of 43 root replacements after previous roots) and reoperative indication (24 of 43 root replacements for endocarditis). Implanted valve prostheses were small for patient size, less so in intact native roots (previous subcoronary or inclusion root) than retained allografts (Z-value, -1.1 versus -1.6; p = 0.08), but allograft root re-replacement allowed normal-sized valves. Patient risks: Relevant postoperative morbidities inclu...Continue Reading

References

Jul 1, 1985·Circulation·S B CalderwoodM J Buckley
Apr 1, 1984·The Annals of Thoracic Surgery·A R Dobell, A K Jain
Aug 1, 1995·The Annals of Thoracic Surgery·M F O'Brien
Feb 25, 1998·The Journal of Thoracic and Cardiovascular Surgery·J R DotyD B Doty
Sep 23, 2003·The Journal of Thoracic and Cardiovascular Surgery·Eugene H BlackstoneAkiko Chai
Jun 29, 2005·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·Abraham Charles YankahRoland Hetzer
Mar 30, 2007·JAMA : the Journal of the American Medical Association·Andrew WangUNKNOWN International Collaboration on Endocarditis-Prospective Cohort Study Investigators
Feb 5, 2008·The Journal of Thoracic and Cardiovascular Surgery·Eric E RoselliBruce W Lytle

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Citations

May 7, 2010·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·Paul P UrbanskiAnno Diegeler
Jan 14, 2011·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·Jos A BekkersAd J J C Bogers
Nov 15, 2011·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·Anke KowertEckehard Kilian
Aug 31, 2012·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·Jonathan FinchJohn Pepper
Aug 28, 2012·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·Alec VahanianUNKNOWN European Association for Cardio-Thoracic Surgery (EACTS)
Aug 28, 2012·European Heart Journal·UNKNOWN Joint Task Force on the Management of Valvular Heart Disease of the European Society of Cardiology (ESC)Marian Zembala
Nov 5, 2013·The Annals of Thoracic Surgery·Thierry A Folliguet, François Laborde
May 25, 2013·The Annals of Thoracic Surgery·Lars G SvenssonMathew R Williams
Jul 6, 2010·The Journal of Thoracic and Cardiovascular Surgery·Daniel Pereda, Soon J Park
Aug 8, 2009·The Journal of Thoracic and Cardiovascular Surgery·Michael SchmoeckelBruno Reichart
Mar 1, 2011·The Annals of Thoracic Surgery·Pietro G MalvindiWim J Morshuis
Jul 6, 2014·Interactive Cardiovascular and Thoracic Surgery·Katharina MeszarosThierry P Carrel
Mar 11, 2015·The Annals of Thoracic Surgery·Arminder S JassarJoseph E Bavaria
Dec 8, 2010·Journal of Cardiovascular Medicine·Azita S RouhaniUberto Bortolotti
Jan 28, 2010·Journal of Cardiovascular Medicine·Giacomo RavenniUberto Bortolotti
Apr 22, 2020·Future Cardiology·Alice Le Huu, Dominique Shum-Tim
Jun 1, 2019·Indian Journal of Thoracic and Cardiovascular Surgery : Official Organ, Association of Thoracic and Cardiovascular Surgeons of India·Giuseppe Filiberto SerrainoGiovanni Mariscalco
Sep 29, 2020·The Annals of Thoracic Surgery·James C WittenGösta B Pettersson

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