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Hospital Results of a Single Center Database for Stentless Xenograft Use in a Full Root Technique in Over 970 Patients
Our aim was to analyse the hospital outcome for the worldwide largest series of stentless bioroot xenografts (Medtronic Freestyle) as full root replacement in a single centre over a period of 18 years. Retrospective data analysis was performed for the entire cohort of patients undergoing aortic root...
Autores principales: | , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Nature Publishing Group UK
2019
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6416277/ https://www.ncbi.nlm.nih.gov/pubmed/30867492 http://dx.doi.org/10.1038/s41598-019-40772-7 |
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author | Easo, Jerry Weymann, Alexander Hölzl, Philipp Horst, Michael Eichstaedt, Harald Mashhour, Ahmed Zhigalov, Konstantin Szczechowicz, Marcin Thomas, Rohit Philip Sabashnikov, Anton Dapunt, Otto E. |
author_facet | Easo, Jerry Weymann, Alexander Hölzl, Philipp Horst, Michael Eichstaedt, Harald Mashhour, Ahmed Zhigalov, Konstantin Szczechowicz, Marcin Thomas, Rohit Philip Sabashnikov, Anton Dapunt, Otto E. |
author_sort | Easo, Jerry |
collection | PubMed |
description | Our aim was to analyse the hospital outcome for the worldwide largest series of stentless bioroot xenografts (Medtronic Freestyle) as full root replacement in a single centre over a period of 18 years. Retrospective data analysis was performed for the entire cohort of patients undergoing aortic root surgery with the Medtronic Freestyle valve prosthesis. Logistic regression analysis was performed to analyse predictors of in-hospital mortality. 971 patients underwent aortic full root replacement with the Medtronic Freestyle valve in the period from 1999–2017, with an average age of 68.8 ± 10.3y and gender distribution of 608:363 (male:female). Concomitant surgery was performed in 693 patients (71.4%). In-hospital all-comers mortality was 9.8% (95 patients), with the respective highest risk profiles including dissections (6.4%), endocarditis (5.6%) and re-do procedures (12.5%). In-hospital mortality for elective patients was 7.6% while isolated aortic root replacement demonstrated a mortality of 3.6%. Logistic regression analysis demonstrated age (OR 1.05, p = 0.005), dissection (OR 5.78, p < 0.001) and concomitant bypass surgery (OR 2.68, p < 0.001) as preoperative risk factors for the entire cohort. Postoperative analysis demonstrated myocardial infarction (OR 48.6, p < 0.001) and acute kidney injury (OR 20.2, p < 0.001) to be independent risk factors influencing mortality. This analysis presents a work-through of all patients with stentless bioroot treatment without positive selection in a high-volume clinical center with the largest experience world-wide for this form of complex surgery. Isolated aortic root replacement could be performed at acceptable operative risk for this technically-challenging procedure. |
format | Online Article Text |
id | pubmed-6416277 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | Nature Publishing Group UK |
record_format | MEDLINE/PubMed |
spelling | pubmed-64162772019-03-15 Hospital Results of a Single Center Database for Stentless Xenograft Use in a Full Root Technique in Over 970 Patients Easo, Jerry Weymann, Alexander Hölzl, Philipp Horst, Michael Eichstaedt, Harald Mashhour, Ahmed Zhigalov, Konstantin Szczechowicz, Marcin Thomas, Rohit Philip Sabashnikov, Anton Dapunt, Otto E. Sci Rep Article Our aim was to analyse the hospital outcome for the worldwide largest series of stentless bioroot xenografts (Medtronic Freestyle) as full root replacement in a single centre over a period of 18 years. Retrospective data analysis was performed for the entire cohort of patients undergoing aortic root surgery with the Medtronic Freestyle valve prosthesis. Logistic regression analysis was performed to analyse predictors of in-hospital mortality. 971 patients underwent aortic full root replacement with the Medtronic Freestyle valve in the period from 1999–2017, with an average age of 68.8 ± 10.3y and gender distribution of 608:363 (male:female). Concomitant surgery was performed in 693 patients (71.4%). In-hospital all-comers mortality was 9.8% (95 patients), with the respective highest risk profiles including dissections (6.4%), endocarditis (5.6%) and re-do procedures (12.5%). In-hospital mortality for elective patients was 7.6% while isolated aortic root replacement demonstrated a mortality of 3.6%. Logistic regression analysis demonstrated age (OR 1.05, p = 0.005), dissection (OR 5.78, p < 0.001) and concomitant bypass surgery (OR 2.68, p < 0.001) as preoperative risk factors for the entire cohort. Postoperative analysis demonstrated myocardial infarction (OR 48.6, p < 0.001) and acute kidney injury (OR 20.2, p < 0.001) to be independent risk factors influencing mortality. This analysis presents a work-through of all patients with stentless bioroot treatment without positive selection in a high-volume clinical center with the largest experience world-wide for this form of complex surgery. Isolated aortic root replacement could be performed at acceptable operative risk for this technically-challenging procedure. Nature Publishing Group UK 2019-03-13 /pmc/articles/PMC6416277/ /pubmed/30867492 http://dx.doi.org/10.1038/s41598-019-40772-7 Text en © The Author(s) 2019 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/. |
spellingShingle | Article Easo, Jerry Weymann, Alexander Hölzl, Philipp Horst, Michael Eichstaedt, Harald Mashhour, Ahmed Zhigalov, Konstantin Szczechowicz, Marcin Thomas, Rohit Philip Sabashnikov, Anton Dapunt, Otto E. Hospital Results of a Single Center Database for Stentless Xenograft Use in a Full Root Technique in Over 970 Patients |
title | Hospital Results of a Single Center Database for Stentless Xenograft Use in a Full Root Technique in Over 970 Patients |
title_full | Hospital Results of a Single Center Database for Stentless Xenograft Use in a Full Root Technique in Over 970 Patients |
title_fullStr | Hospital Results of a Single Center Database for Stentless Xenograft Use in a Full Root Technique in Over 970 Patients |
title_full_unstemmed | Hospital Results of a Single Center Database for Stentless Xenograft Use in a Full Root Technique in Over 970 Patients |
title_short | Hospital Results of a Single Center Database for Stentless Xenograft Use in a Full Root Technique in Over 970 Patients |
title_sort | hospital results of a single center database for stentless xenograft use in a full root technique in over 970 patients |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6416277/ https://www.ncbi.nlm.nih.gov/pubmed/30867492 http://dx.doi.org/10.1038/s41598-019-40772-7 |
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