Early experience with a prefabricated bioprosthetic aortic valved conduit: The first 100

Objective

To evaluate the early postoperative morbidity, mortality, and prosthetic conduit function of patients who underwent aortic root replacement using a prefabricated bioprosthetic aortic valved conduit.

Methods

Single-center retrospective review of 124 consecutive adult patients who underwent aortic root replacement with a certified prefabricated bioprosthetic aortic valved conduit from 2021 to December 2023.

Results

Indications for operation were aortic aneurysms (n = 92), endocarditis (n = 12), deterioration of prior valve prosthesis (n = 13), and aortic dissection (n = 6). Implanted valve sizes were 29 mm (n = 37), 27 mm (n = 41), 25 mm (n = 31), 23 mm (n = 14), and 21 mm (n = 1). Isolated aortic root repair was performed in 48 patients, concomitant hemiarch in 69 patients and total arch in 7 patients. Thirty-day mortality rate was 5% (n = 6), permanent pacemaker implantation was necessary in 14% (n = 17), reoperation for bleeding in 4% (n = 5), and only 1 patient developed postoperative stroke. Discharge echocardiogram was available in 118 patients, and follow-up assessment in 45 patients. Prosthetic aortic valve gradient, effective orifice area, and Doppler velocity index remained within normal limits.

Conclusions

The prefabricated bioprosthetic aortic valved conduit was used in all settings, including complex reoperations, acute dissection, and endocarditis with acceptable short-term morbidity and mortality. The hemodynamic performance of the valve within the studied period was normal, the long-term durability and hemodynamic performance are yet to be proven.