|
Homografts in Patients with Combined Disease of the Aortic Valve and the Ascending Aorta: An Alternative to the Classical Bentall Procedure The use of homografts for aortic valve replacement extended by a vascular prosthesis may be an alternative to the classical Bentall procedure. Thirty patients with indications for aortic valve replacement and endocarditis of a previously placed bioprosthesis were enrolled. The mean diameter of the ascending aorta was 5.6 ± 0.5 cm. For valve replacement, cryopreserved homografts (mean size 24 ± 2 mm) were used in a mini-root technique; the ascending aorta was replaced with collagen-coated vascular prostheses (mean diameter 28 ± 3 mm). All patients survived surgery, and none died during follow up. No patient had postoperative anticoagulation, and no thromboembolic events were noted. Average follow up was 48 months (range: 6-84 months). Doppler echocardiography revealed trivial to mild aortic regurgitation in nine patients, with no deterioration during follow up. No pathologic pressure gradients over the aortic valves were measured, and mean valvular orifice area was 2.5 ± 0.3 cm2. At ultrafast CT, normal homograft anatomy including the sinutubular junction was seen; neither was there any calcification or signs of annular dilatation. In conclusion, short- and mid-term results showed that cryopreserved homografts extended by small-sized vascular prostheses can be used safely for Bentall procedures when the aortic valve annulus is moderately dilated. |
650 |