Contemporary results of aortic root replacement with a novel prosthesis in 143 patients

S. Rooney, S. Langley, M. Dalrymple-Hay, M. Lewis, J. Spencer, D. Pagano, M. Asif, V. Tsang, R. Lamb, J. Monro, S. Livesey, R. S. Bonser

Research output: Contribution to journalArticle

Abstract

Replacement of the aortic root is undertaken for a variety of different pathological conditions. We report the combined early results from two centres in the United Kingdom using a composite valve graft conduit consisting of a bileaflet mechanical valve incorporated into a gelatin impregnated, ultra-low porosity woven polyester graft (Carbo-Seal®). Between August 1992 and March 1997, 143 patients underwent aortic root replacement with the Carbo-Seal® composite prosthesis. There were 112 males (78%) and 31 females (22%) with a mean age of 56.4 years (range 15-80). The indication for surgery was acute type A dissection in 31 (22%), chronic type A dissection in 9 (6%), ascending aortic aneurysm without dissection in 100 (70%) and false aneurysm of the ascending aorta in 3 (2%). Twenty seven patients (19%) had undergone previous sternotomy and 40 (28%) were emergencies. Concomitant procedures were performed in 38 (27%), including 18 aortic arch or hemi-arch replacements. Marfan's syndrome was present in 27 (19%). Total follow up is 270 patient years. Follow up is 100% complete. The early (30 day) mortality was 7% (10 patients). Fourteen patients (10%) were re-explored for bleeding, however in no case was this related to the prosthesis. Permanent neurological events occurred in 2%. At a mean follow up of 23 months 94% of survivors were in NYHA class I. Freedom from reoperation was 97.2%±1.6 (1SE) at 12 months and 95.7%±2.1 at 48 months. Including early mortality, survival was 90.1%±2.6 at 12 months and 86.0%±3.5 at 48 months. These early and mid-term results suggest that this composite is an appropriate prosthesis to select for aortic root replacement.

Original languageEnglish (US)
JournalHeart
Volume79
Issue numberSUPPL. 1
StatePublished - May 1998
Externally publishedYes

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Prostheses and Implants
Dissection
Charcoal
Transplants
Marfan Syndrome
Polyesters
Sternotomy
Mortality
Aortic Aneurysm
Porosity
False Aneurysm
Gelatin
Thoracic Aorta
Reoperation
Survivors
Aorta
Emergencies
Hemorrhage
Survival

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Rooney, S., Langley, S., Dalrymple-Hay, M., Lewis, M., Spencer, J., Pagano, D., ... Bonser, R. S. (1998). Contemporary results of aortic root replacement with a novel prosthesis in 143 patients. Heart, 79(SUPPL. 1).

Contemporary results of aortic root replacement with a novel prosthesis in 143 patients. / Rooney, S.; Langley, S.; Dalrymple-Hay, M.; Lewis, M.; Spencer, J.; Pagano, D.; Asif, M.; Tsang, V.; Lamb, R.; Monro, J.; Livesey, S.; Bonser, R. S.

In: Heart, Vol. 79, No. SUPPL. 1, 05.1998.

Research output: Contribution to journalArticle

Rooney, S, Langley, S, Dalrymple-Hay, M, Lewis, M, Spencer, J, Pagano, D, Asif, M, Tsang, V, Lamb, R, Monro, J, Livesey, S & Bonser, RS 1998, 'Contemporary results of aortic root replacement with a novel prosthesis in 143 patients', Heart, vol. 79, no. SUPPL. 1.
Rooney S, Langley S, Dalrymple-Hay M, Lewis M, Spencer J, Pagano D et al. Contemporary results of aortic root replacement with a novel prosthesis in 143 patients. Heart. 1998 May;79(SUPPL. 1).
Rooney, S. ; Langley, S. ; Dalrymple-Hay, M. ; Lewis, M. ; Spencer, J. ; Pagano, D. ; Asif, M. ; Tsang, V. ; Lamb, R. ; Monro, J. ; Livesey, S. ; Bonser, R. S. / Contemporary results of aortic root replacement with a novel prosthesis in 143 patients. In: Heart. 1998 ; Vol. 79, No. SUPPL. 1.
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abstract = "Replacement of the aortic root is undertaken for a variety of different pathological conditions. We report the combined early results from two centres in the United Kingdom using a composite valve graft conduit consisting of a bileaflet mechanical valve incorporated into a gelatin impregnated, ultra-low porosity woven polyester graft (Carbo-Seal{\circledR}). Between August 1992 and March 1997, 143 patients underwent aortic root replacement with the Carbo-Seal{\circledR} composite prosthesis. There were 112 males (78{\%}) and 31 females (22{\%}) with a mean age of 56.4 years (range 15-80). The indication for surgery was acute type A dissection in 31 (22{\%}), chronic type A dissection in 9 (6{\%}), ascending aortic aneurysm without dissection in 100 (70{\%}) and false aneurysm of the ascending aorta in 3 (2{\%}). Twenty seven patients (19{\%}) had undergone previous sternotomy and 40 (28{\%}) were emergencies. Concomitant procedures were performed in 38 (27{\%}), including 18 aortic arch or hemi-arch replacements. Marfan's syndrome was present in 27 (19{\%}). Total follow up is 270 patient years. Follow up is 100{\%} complete. The early (30 day) mortality was 7{\%} (10 patients). Fourteen patients (10{\%}) were re-explored for bleeding, however in no case was this related to the prosthesis. Permanent neurological events occurred in 2{\%}. At a mean follow up of 23 months 94{\%} of survivors were in NYHA class I. Freedom from reoperation was 97.2{\%}±1.6 (1SE) at 12 months and 95.7{\%}±2.1 at 48 months. Including early mortality, survival was 90.1{\%}±2.6 at 12 months and 86.0{\%}±3.5 at 48 months. These early and mid-term results suggest that this composite is an appropriate prosthesis to select for aortic root replacement.",
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AU - Pagano, D.

AU - Asif, M.

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