| Homograft implantation for aortic valve replacement since 15 years: results and follow-up. | |
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MedLine Citation:
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PMID: 20719726 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: The use of homografts in aortic valve replacement is an alternative to other prostheses and has been established in our department for 15 years. METHODS: Since 1992, 360 homografts (HG) have been implanted in adult patients (mean age 51.6 years, 72.8% male). Prospective follow-up was done on an annual basis. RESULTS: Thirty-day mortality was 5.0% (n = 17); after 5, 10, and 15 years, survival was 88.3%, 84.6%, and 76.0%, respectively. Out of 39 late deaths, 11 were valve-related (10 HG infections, 1 aortic aneurysm). Freedom from reoperation was 99.4% 1 year after operation; after 5, 10, and 15 years it was 94.1%, 78.2%, and 67.3%, respectively. Indications for HG explantation were graft infections (n = 20), calcification (n = 16), regurgitation > grade II (n = 17), perforation (n = 8), and paravalvular leakage (n = 1). Eleven transitoric ischemic attacks, 2 strokes, and 1 cerebral bleeding event were recorded. In echocardiography, the transvalvular pressure gradient changed from 10.55 to 15.02 (P = .004), 19.9 mmHg (P = .056), and 37 mmHg (not applicable) after 5, 10, and 15 years, respectively. Mean HG regurgitation was grade 0.49 before discharge and increased to 1.0 (P < .001), 0.91, and 2.5 after 5, 10, and 15 years, respectively. Ejection fraction increased from 61.9% to 64% after 5 years and to 66% after 10 years (P = .021) and then decreased to 63.5% after 15 years. CONCLUSIONS: Comparing HG with other valve prostheses, survival and graft durability seem to be confirmed. They are vulnerable to infections. The hemodynamic performance is good, and hemorrhagic or thrombo-embolic events are rare. |
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Authors:
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Eckehard Kilian; Florian Fries; Anke Kowert; Ferdinand Vogt; Eckart Kreuzer; Bruno Reichart |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: The heart surgery forum Volume: 13 ISSN: 1522-6662 ISO Abbreviation: Heart Surg Forum Publication Date: 2010 Aug |
Date Detail:
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Created Date: 2010-08-19 Completed Date: 2011-01-04 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 100891112 Medline TA: Heart Surg Forum Country: United States |
Other Details:
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Languages: eng Pagination: E238-42 Citation Subset: IM |
Affiliation:
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Department of Cardiac Surgery, Ludwig-Maximilians-University, University Hospital Grosshadern, Munich, Germany. Ec.Ki@web.de |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adolescent Adult Aged Aged, 80 and over Aortic Valve / microbiology, transplantation* Aortic Valve Insufficiency / surgery*, ultrasonography Cardiac Surgical Procedures / adverse effects, mortality Child Echocardiography Female Follow-Up Studies Hemodynamics Humans Infection / etiology Kaplan-Meier Estimate Male Middle Aged Postoperative Complications / surgery Postoperative Period Prospective Studies Reoperation / statistics & numerical data Time Factors Transplantation, Homologous / adverse effects Young Adult |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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