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You are here: Contents > 2012 > Volume 21 Number 1 January 2012 > AORTIC VALVE DISEASE > Aortic Valve Re-Replacement after Bentall Procedure with a Biological Valved Conduit in a Sheep Model

Aortic Valve Re-Replacement after Bentall Procedure with a Biological Valved Conduit in a Sheep Model

Hassina Baraki, Igor Tudorache, Klaus Hoeffler, Nawid Khaladj, Christian Hagl, Serghei Cebotari, Axel Haverich, Malakh Shrestha 

Department of Cardiothoracic, Transplantation, and Vascular Surgery, Hannover Medical School, Hannover, Germany

Background and aim of the study: The Bentall procedure is the ‘gold standard’ for the repair of a combined pathology of ascending aorta and aortic valve. Because there is no need for long-term anticoagulation, biological-valved conduits have become increasingly popular; however, the possible need for reoperation due to valve degeneration is a major disadvantage. The aim of this animal-based study was to prove the feasibility of an isolated replacement of the aortic valve prosthesis six months after a previous implantation of a biological valved conduit (BioValsalva™) in a sheep model.
Methods: A total aortic root replacement, using the BioValsalva conduit, was performed in 10 juvenile sheep. After six months, the surviving sheep were reoperated on, and the stentless valve was replaced with a stented biological valve placed inside the previously implanted vascular conduit.

Results: Five animals survived the initial implantation of a BioValsalva conduit. During reoperation, the triple-layered vascular graft with polytetrafluoroethylene on the outside showed only slight adhesions with the surrounding tissue. The stentless valve was removed in one piece, after which a new stented valve was implanted inside the conduit. An X-radiographic examination of the explanted valve showed moderate calcification of the leaflet, and severe calcification of the aortic wall.
Conclusion: The results of this animal study confirmed that a degenerated stentless biological valve inside the BioValsalva conduit could be replaced with a new valve, without having to remove the entire conduit.


The Journal of Heart Valve Disease 2012;21:5-11

Aortic Valve Re-Replacement after Bentall Procedure with a Biological Valved Conduit in a Sheep Model

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