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Aortic Valve Reoperation After Stentless Bioprosthesis: Short- and Long-Term Outcomes.


ABSTRACT: BACKGROUND:Limited data are available regarding outcomes for stentless aortic valve reoperation. The reported reoperative mortality has been unacceptably high. METHODS:Between 1997 and 2017, a retrospective analysis was performed on 143 patients who underwent open aortic valve reoperations for failed stentless aortic valve bioprostheses. We evaluated both short-term and long-term outcomes on this cohort of patients. RESULTS:Bicuspid aortic valve was present in 107 of 143 patients (75%) at the time of the initial Freestyle (Medtronic, Minneapolis, MN) procedure, and 120 of 143 patients (84%) underwent a modified inclusion aortic root replacement procedure. The interval from first operation to reoperation was 9 years (range, 5.4 to 11.8), which was significantly shorter for patients with infectious endocarditis (4.1 years; range, 1.8 to 7.1) compared with patients with structural valvular deterioration (10.4 years; range, 8.1 to 12.4, p < 0.001). The median age at the time of reoperation was 59 years (range, 50 to 67). Aortic valve reoperation was performed for structural valve deterioration in 68% cases compared with 32% for infectious prosthetic valve endocarditis. Concomitant surgery included coronary artery bypass (13%), mitral valve surgery (4%), and ascending aorta and arch replacement (42%). The 30-day and inhospital mortality was 1% and 2%, respectively. The composite outcome including myocardial infarction, stroke, new-onset renal failure on hemodialysis, and operative mortality was 4%. The 5-year and 10-year Kaplan-Meier survival after reoperation for failed stentless valve was 83% (95% confidence interval: 73% to 89%) and 57% (95% confidence interval: 36% to 74%). CONCLUSIONS:Aortic valve reoperation after stentless valve implantation can be performed with low operative mortality and favorable long-term survival.

SUBMITTER: Yang B 

PROVIDER: S-EPMC6669885 | biostudies-literature | 2018 Aug

REPOSITORIES: biostudies-literature

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Aortic Valve Reoperation After Stentless Bioprosthesis: Short- and Long-Term Outcomes.

Yang Bo B   Patel Himanshu J HJ   Norton Elizabeth L EL   Debenedictus Christina C   Farhat Linda L   Wu Xiaoting X   He Kevin K   Hornsby Whitney E WE   Likosky Donald S DS   Deeb G Michael GM  

The Annals of thoracic surgery 20180403 2


<h4>Background</h4>Limited data are available regarding outcomes for stentless aortic valve reoperation. The reported reoperative mortality has been unacceptably high.<h4>Methods</h4>Between 1997 and 2017, a retrospective analysis was performed on 143 patients who underwent open aortic valve reoperations for failed stentless aortic valve bioprostheses. We evaluated both short-term and long-term outcomes on this cohort of patients.<h4>Results</h4>Bicuspid aortic valve was present in 107 of 143 pa  ...[more]

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