Abstract
Background
The purpose of this study is to examine our experience with aortic root replacement using composite valve grafts in patients with proximal aortic disease.
Methods and Results
Since 1986, 16 patients underwent aortic root replacement using composite valve grafts for various indications which were Marfan's syndrome with annuloaortic ectasia (n=2), aortic regurgitation with ascending aortic aneurysm (n=3), aortic stenosis with regurgitation with poststenotic dilatation (n=9) and progressive aortic dilatation following AVR (n=2). There were 12 males and 4 females. The age range varied between 19 years and 52 years. The choice of conduit was a custom made valved graft using a monoleaflet tilting disc valve (Medtronic Hall valve=11, St Vincent's valve=3, TTK Chitra=1 and Bjork Shiley Valve=1) placed in a Dacron graft (Hemashield=13, Verisoft Cooley=3) prepared using a 4-0 polypropylene suture. The average time taken to construct a valved graft was 20 min±8 min. The coronary implantation was by isolated button technique. There was no size mismatch encountered in any patients. Postoperative bleeding necessitated a delayed sternal closure in 3 patients and re-exploration in another 2. The immediate operative mortality was 2, the cause being ventricular arrhythmia in one and cerebrovascular accident in other. Follow-up period ranged from 2 months to 16 years with a median follow-up of 12 months. One patient had an asymptomatic perigraft collection and no intervention was needed. There was no valve related complications in any of these patients. There was one late death of unknown cause.
Conclusions
Aortic root replacement using a custom made composite graft offers excellent long-term results, with negligible mortality rate and prosthesis related complications. Custom made grafts make this conduit easily affordable in our country and their performance is comparable to other available composite grafts.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Aomi S, Nakajima M, Nonoyama M, Tomioka H, Bonkohara Y, Satou W, Kunii Y, Endo M. Aortic root replacement using composite valve graft in patients with aortic valve disease and aneurysm of the ascending aorta: twenty years' experience of late results. Artif Organs 2002; 26: 467–73.
Prifti E, Bonacchi M, Frati G, Prietti P, Giunti G, Babatasi G, Massetti M, Sani G. Early and long-term outcome in patients undergoing aortic root replacement with composite graft according to the Bentall's technique. Eur J Cardiothorac Surg 2002: 12: 15–21.
Pacini D, Ranocchi F, Angeli E, Settepani F, Pagliaro M, Martin-Suarez S, Di Bartolomeo R, Pierangeli A. Aortic root replacement with composite valve graft. Ann Thorac Surg 2003; 76: 90–98.
Hilgenberg AD, Mora BN. Composite aortic root replacement with a bovine pericardial valve conduit. Ann Thorac Surg 2003; 75: 1338–39.
Carrel TP, Berdat P, Englberger L, Eckstein F, Immer F, Seiler C, Kipfer B, Schmidli J. Aortic root replacement with a new stentless aortic valve xenograft conduit: preliminary hemodynamic and clinical results. J Heart Valve Dis 2003; 12: 752–57.
Pratali S, Milano A, Codecasa R, De Carlo M, Borzoni G, Bortolotti U. Improving hemostasis during replacement of the ascending aorta and aortic valve with a composite graft. Tex Heart Inst J 2000; 73: 1130–37.
Halstead JC, Lim E, Ali A, Tsui S, Wallwork J, Dunning J. A versatile technique for aortic root replacement without premanufactured conduit graft: A 12 year experience. J Heart Valve Dis 2004; 13: 717–21.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Nagarajan, M., Varma, S.K., Ramanathan, S. et al. Our experience with aortic root replacement using hand-sewn composite valve graft. Indian J Thorac Cardiovasc Surg 21, 153–156 (2005). https://doi.org/10.1007/s12055-005-0034-2
Received:
Revised:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/s12055-005-0034-2