Acute Aortic Endocarditis with Annular Destruction: Assessment of Surgical
Treatment with Cryopreserved Valvular Homografts Implanted in a Subannular
Position; Follow up ranging from 14 to 76 months
Daniel Grandmougin MD, Alain Prat MD, Georges Fayad MD, Christophe Decoene MD,
Annie Pol MD, Henri Warembourg MD

Annular abscess in acute aortic endocarditis may represent a major anatomic complication, leading to several surgical problems. The surgical treatment of aortic endocarditis with annulus involvement by implantation in a subannular position of cryopreserved valvular homografts was assessed in 25 patients (seven aortic valve replacements; 18 aortic root replacements). Mean follow up was 38 ± 18 months. Hospital mortality rate was 8% and directly related to preoperative NYHA functional class, presence of Staphylococcus spp. in blood cultures, and circular extension of the abscess over-reaching 180^o. Regular echocardiography demonstrated better gradients for root replacements, and confirmed in all cases a good functional and morphologic behavior of the grafts. Nevertheless, discrete calcification of pulmonary conduits may influence the avoidance of such grafts in left ventricular outflow tract reconstruction.