Replacement of the proximal aorta and aortic valve using a composite bileaflet prosthesis and gelatin-impregnated polyester graft (Carbo-Seal): Early results in 143 patients

S. M. Langley, S. J. Rooney, M. J.R. Dalrymple-Hay, J. M.F. Spencer, M. E. Lewis, D. Pagano, M. Asif, J. R. Goddard, V. T. Tsang, R. K. Lamb, J. L. Monro, S. A. Livesey, R. S. Bonser

    Research output: Contribution to journalArticle

    21 Scopus citations

    Abstract

    Objective: We report the combined early results from two centers in the United Kingdom using a composite conduit consisting of a bileaflet mechanical valve incorporated into a gelatin-impregnated, ultra-low porosity, woven polyester graft (Carbo-Seal; Sulzer Carbomedics, Inc, Austin, Tex). Methods: Between August 1992 and March 1997, 143 patients underwent aortic root replacement with the Carbo-Seal composite prosthesis. 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 seen as emergencies. Concomitant procedures were performed in 38 (27%), including 18 aortic arch or hemiarch replacements. Total follow-up is 270 patient-years. Follow-up is 100% complete. Results: The early (30-day) mortality was 7% (10 patients). Permanent neurologic events occurred in 2%. At a mean follow-up of 23 months, 94 % of survivors were in New York Heart Association functional class I. Freedom from reoperation was 97.2% ± 1.6% (1 standard error [1 SE]) at 12 months and 95.7% ± 2.2% at 48 months. Including early mortality, survival was 90.1% ± 2.6% at 12 months and 83.1% ± 3.5% at 48 months. Conclusions: Aortic root replacement with use of the Carbo-Seal prosthesis can be undertaken with a relatively low early mortality and morbidity. A low reoperation rate and high intermediate-term survival can be expected, but continued follow-up is needed to determine the long-term efficacy of this prosthesis.

    Original languageEnglish (US)
    Pages (from-to)1014-1020
    Number of pages7
    JournalJournal of Thoracic and Cardiovascular Surgery
    Volume118
    Issue number6
    DOIs
    StatePublished - Jan 1 1999

    ASJC Scopus subject areas

    • Surgery
    • Pulmonary and Respiratory Medicine
    • Cardiology and Cardiovascular Medicine

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    Langley, S. M., Rooney, S. J., Dalrymple-Hay, M. J. R., Spencer, J. M. F., Lewis, M. E., Pagano, D., Asif, M., Goddard, J. R., Tsang, V. T., Lamb, R. K., Monro, J. L., Livesey, S. A., & Bonser, R. S. (1999). Replacement of the proximal aorta and aortic valve using a composite bileaflet prosthesis and gelatin-impregnated polyester graft (Carbo-Seal): Early results in 143 patients. Journal of Thoracic and Cardiovascular Surgery, 118(6), 1014-1020. https://doi.org/10.1016/S0022-5223(99)70095-4