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Is the Freedom SOLO Stentless Bioprosthesis a Useful Tool for Patients with Aortic Endocarditis and Aortic Annular Destruction?
- Source :
-
The Thoracic and cardiovascular surgeon [Thorac Cardiovasc Surg] 2019 Dec; Vol. 67 (8), pp. 644-651. Date of Electronic Publication: 2018 Aug 16. - Publication Year :
- 2019
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Abstract
- Background: The Freedom SOLO (FS) stentless bovine-pericardial prosthesis with a supra-annular implantation technique can be a viable option for patients with endocarditic annular destruction. We assessed early- and long-term outcomes following the use of this prosthesis in extensive aortic valve endocarditis.<br />Methods: From 2006 to 2016, 59 patients with extensive aortic endocarditis underwent aortic valve replacement (AVR) with FS (cumulative follow-up 263 patients-years) in three European centers; all patients presented annular tissue infection, while 54.3% of patients had annular abscess.<br />Results: Mean age was 66 ± 11 years and mean EuroSCORE I was 30.3% (standard deviation: 24.1%). In our series, 30.5% of patients had prosthetic valve endocarditis. Early mortality was 15.2% (nine patients). Estimated overall survival at 5 and 10 years was 68.9% (95% confidence interval [CI]: 62.8-75.0%) and 59.1% (95% CI: 66.8-81.2%), respectively. At 10-year survival, freedom from valve-related death was 83.7% (95% CI: 80.9-86.5%). No structural valve deterioration was reported in this series. Five patients (8.5%) had recurrent endocarditis during follow-up and two of them underwent reoperation. Survival freedom from reoperation and endocarditis at 10-year follow-up was 88.0% (CI: 80.4-95.6%) and 86.7% (CI: 80.5-92.9%), respectively.<br />Conclusion: FS stentless bioprosthesis is a valuable and simple option to achieve AVR in patients with extensive aortic annulus endocarditis. Although in this group of complex patients, early mortality remains considerably high, late survival outcomes are comparable to the more technically demanding homografts and conventional stentless bioprostheses, with low rates of endocarditis recurrence.<br />Competing Interests: Repossini, MD, Fischlein, MD, Grubitsch, MD, and Muneretto, MD, are consultant for Livanova Company. Santarpino, MD, is a consultant for Sorin Italia.<br /> (Georg Thieme Verlag KG Stuttgart · New York.)
- Subjects :
- Aged
Aortic Valve physiopathology
Endocarditis diagnosis
Endocarditis mortality
Endocarditis physiopathology
Europe
Female
Germany
Heart Valve Prosthesis Implantation adverse effects
Heart Valve Prosthesis Implantation mortality
Humans
Male
Middle Aged
Postoperative Complications mortality
Postoperative Complications surgery
Progression-Free Survival
Prosthesis Design
Recovery of Function
Recurrence
Reoperation
Retrospective Studies
Risk Factors
Time Factors
Aortic Valve surgery
Bioprosthesis
Endocarditis therapy
Heart Valve Prosthesis
Heart Valve Prosthesis Implantation instrumentation
Subjects
Details
- Language :
- English
- ISSN :
- 1439-1902
- Volume :
- 67
- Issue :
- 8
- Database :
- MEDLINE
- Journal :
- The Thoracic and cardiovascular surgeon
- Publication Type :
- Academic Journal
- Accession number :
- 30114715
- Full Text :
- https://doi.org/10.1055/s-0038-1668134