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- Title
Long-term follow-up after Bentall operation using a stentless Shelhigh NR-2000 bio-conduit.
- Authors
Stefanelli, Guglielmo; Pirro, Fabrizio; Macchione, Andrea; Bellisario, Alessandro; Weltert, Luca
- Abstract
<bold>Background: </bold>To analyze the long-term results after Bentall operation using the stentless Shelhigh No-React (NR)-2000 bio-root prosthesis.<bold>Material: </bold>From 2004 to 2008, 26 consecutive, nonselected patients (mean age at surgery: 67 ± 9 years) underwent a Bentall operation using a stentless Shelhigh valved conduit at our institution. Mean preoperative Logistic-EuroSCORE was 17.1 ± 12.9. The mean size of the aortic root was 53.2 ± 5 mm. The mean preoperative ejection fraction was 55 ± 7.4%. Three patients had a bicuspid valve. One patient with acute endocarditis and one patient with type A aortic dissection were operated on an emergency. Three patients (11.54%) had a previous cardiac operation. The Button-Bentall technique was used in all cases. Seven patients (26.92%) received an associated procedure. The mean size of the implanted prosthesis was 26.1 ± 2.2. Follow-up ranged between 6 and 174 months (mean 93.4 ± 59.1 months). Primary endpoints consisted of early and late mortality, freedom from acute endocarditis, freedom from structural valve deterioration, and freedom from valve-related-reoperation.<bold>Results: </bold>Two patients died in hospital, while 10 patients died during follow-up time, of which three for cardiac causes (12.5%). Overall survival probability was 52.9% at 15 years. Freedom from acute endocarditis was 95.7% at 5 and 15 years. Freedom from severe aortic incompetence due to structural deterioration was 100% at 5 and 10 years, 90.9% at 15 years. The mean aortic gradient at follow-up was 11.4 ± 5 mm Hg. Freedom from valve-related reoperation was 100% at 5 and 10 years, 90.9% at 15 years.<bold>Conclusions: </bold>In our experience, Bentall's operation using the Shelhigh NR-2000 stentless bio-conduit provided satisfactory early and long-term results. However, our findings are not consistent with unfavorable long-term outcomes following the implantation of this device reported by other authors.
- Subjects
AORTIC valve insufficiency; MITRAL valve; AORTIC dissection; HOSPITAL patients; TERMINALLY ill; URINARY diversion; AORTIC valve surgery; AORTIC valve abnormalities; PROSTHETIC heart valves; HEART valve diseases; INFECTIVE endocarditis; LONGITUDINAL method; PROSTHETICS; TIME; TREATMENT effectiveness; DISSECTING aneurysms
- Publication
Journal of Cardiac Surgery, 2020, Vol 35, Issue 5, p988
- ISSN
0886-0440
- Publication type
journal article
- DOI
10.1111/jocs.14510