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  • Dagnegård, H.H.Department of Cardiothoracic Surgery, Rigshospitalet, University Hospital of Copenhagen, Copenhagen, Denmark; Department of Cardiology, Rigshospitalet, University Hospital of Copenhagen, Copenhagen, Denmark; Department of Clinical Medicine, Copenhagen University, Copenhagen, Denmark (author)

Survival after aortic root replacement with a stentless xenograft is determined by patient characteristics

  • Article/chapterEnglish2022

Publisher, publication year, extent ...

  • Mosby Inc.; Elsevier Inc.2022
  • electronicrdacarrier

Numbers

  • LIBRIS-ID:oai:DiVA.org:liu-184194
  • https://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-184194URI
  • https://doi.org/10.1016/j.jtcvs.2021.07.011DOI
  • http://kipublications.ki.se/Default.aspx?queryparsed=id:152097791URI

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  • Language:English
  • Summary in:English

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  • Subject category:ref swepub-contenttype
  • Subject category:art swepub-publicationtype

Notes

  • Objectives: Our objective was to examine intermediate-term survival and reinterventions in unselected patients, stratified according to indication, who received a Freestyle (Medtronic Inc, Minneapolis, Minn) bioprosthesis as a full aortic root replacement. Methods: Data from medical records were retrospectively collected for patients who had aortic root replacement using Freestyle bioprostheses between 1999 and 2018 at 6 North-Atlantic centers. Survival status was extracted from national registries and results stratified according to indication for surgery. Results: We included 1030 implantations in 1008 patients with elective indications for surgery: aneurysm (39.8%), small root (8.3%), and other (13.8%), and urgent/emergent indications: endocarditis (26.7%) and Stanford type A aortic dissection (11.4%). Across indications, 46.3% were nonelective cases and 34.0% were reoperations. Median age was 66.0 (interquartile range, 58.0-71.8) years and median follow-up was 5.0 (interquartile range, 2.6-7.9) years. Thirty-day mortality varied from 2.9% to 27.4% depending on indication. Intermediate survival for 90-day survivors with elective indications were not different from the general population standardized for age and sex (P = .95, 83, and .16 for aneurysms, small roots, and other, respectively). In contrast, patients with endocarditis and type A dissection had excess mortality (P < .001). Freedom from valve reinterventions was 95.0% and 94.4% at 5 and 8 years, respectively. In all, 52 patients (5.2%) underwent reinterventions, most because of endocarditis. Conclusions: At intermediate term follow-up this retrospective study provides further support for the use of the Freestyle bioprosthesis in the real-world setting of diverse, complex, and often high-risk aortic root replacement and suggests that outcome is determined by patient and disease, rather than by prosthesis, characteristics. © 2021 The Authors

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  • Bekke, K.Department of Cardiothoracic Surgery, Rigshospitalet, University Hospital of Copenhagen, Copenhagen, Denmark (author)
  • Kolseth, S.M.Department of Heart Disease, Haukeland University Hospital and University of Bergen, Bergen, Norway (author)
  • Glaser, N.Karolinska Institutet (author)
  • Wallén, C.Linköpings universitet,Institutionen för hälsa, medicin och vård,Medicinska fakulteten,Region Östergötland, Kardiologiska kliniken US(Swepub:liu)n/a (author)
  • El-Hamamsy, I.Montreal Heart Institute, University of Montreal, Montreal, QC, Canada (author)
  • Vidisson, K.O.Department of Cardiothoracic Surgery, Landspítali University Hospital, Faculty of Medicine, University of Iceland, Reykjavik, Iceland (author)
  • Lie, A.S.Department of Heart Disease, Haukeland University Hospital and University of Bergen, Bergen, Norway (author)
  • Valentin, J.B.Danish Center for Clinical Health Services Research (DACS), Department of Clinical Medicine, Aalborg University and Aalborg University Hospital, Aalborg, Denmark (author)
  • Sartipy, U.Karolinska Institutet (author)
  • Haaverstad, R.Department of Heart Disease, Haukeland University Hospital and University of Bergen, Bergen, Norway (author)
  • Vanky, FarkasLinköpings universitet,Avdelningen för diagnostik och specialistmedicin,Medicinska fakulteten,Region Östergötland, Thorax-kärlkliniken i Östergötland(Swepub:liu)farva32 (author)
  • Lefebvre, L.Montreal Heart Institute, University of Montreal, Montreal, QC, Canada (author)
  • Gudbjartsson, T.Department of Cardiothoracic Surgery, Landspítali University Hospital, Faculty of Medicine, University of Iceland, Reykjavik, Iceland (author)
  • Johnsen, S.P.Danish Center for Clinical Health Services Research (DACS), Department of Clinical Medicine, Aalborg University and Aalborg University Hospital, Aalborg, Denmark (author)
  • Søndergaard, L.Department of Cardiology, Rigshospitalet, University Hospital of Copenhagen, Copenhagen, Denmark; Department of Clinical Medicine, Copenhagen University, Copenhagen, Denmark (author)
  • Thyregod, G.H.Department of Cardiothoracic Surgery, Rigshospitalet, University Hospital of Copenhagen, Copenhagen, Denmark (author)
  • Lund, J.T.Cardio Thoracic Surgical Department, Green Lane Division, Auckland City Hospital, Auckland, New Zealand (author)
  • Ihlemann, N.Department of Cardiology, Rigshospitalet, University Hospital of Copenhagen, Copenhagen, Denmark (author)
  • Smerup, M.H.Department of Cardiothoracic Surgery, Rigshospitalet, University Hospital of Copenhagen, Copenhagen, Denmark; Department of Clinical Medicine, Copenhagen University, Copenhagen, Denmark (author)
  • Department of Cardiothoracic Surgery, Rigshospitalet, University Hospital of Copenhagen, Copenhagen, Denmark; Department of Cardiology, Rigshospitalet, University Hospital of Copenhagen, Copenhagen, Denmark; Department of Clinical Medicine, Copenhagen University, Copenhagen, DenmarkDepartment of Cardiothoracic Surgery, Rigshospitalet, University Hospital of Copenhagen, Copenhagen, Denmark (creator_code:org_t)

Related titles

  • In:Journal of Thoracic and Cardiovascular Surgery: Mosby Inc.; Elsevier Inc.164:6, s. 1712-17240022-52231097-685X

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