Comparison of mid-term haemodynamic performance between the BioValsalva and the BioIntegral valved conduits after aortic root replacement

Wendt, Daniel; Raweh, Ayman; Knipp, Stephan; Gabry, Mohammed El; Eißmann, Mareike; Dohle, Daniel-Sebastian; Tsagakis, Konstantinos; Thielmann, Matthias; Jakob, Heinz; Benedı́k, Jaroslav

doi:10.1093/icvts/ivw066

Cited by 13 publications

(11 citation statements)

References 13 publications

(11 reference statements)

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“…Moreover, there was no statistically significant difference in aortic regurgitation between the two conduits. 36 We could confirm the results of the postoperative BioIntegral by echocardiography with comparable early postoperative median MPGs of 11.3 mm Hg and also high median aortic root diameter of $27.5 mm without any aortic regurgitation. Prevenza et al examined the early and midterm outcomes of homograft use in 355 patients for reoperative aortic root and proximal aortic surgery for mainly endocarditis patients and estimated the associated risk of postoperative reinfection.…”

Section: Discussionsupporting

confidence: 72%

Outcomes of Patients after Implantation of the Pericardial All-Biological Valve No-React Aortic Conduit (BioIntegral) for Root Replacement in Complex Surgical Procedures

Puehler

Freitag‐Wolf

Friedrich

et al. 2019

Thorac Cardiovasc Surg

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Objective Therapy of complex aortic root pathologies remains a great surgical challenge. Though different graft materials are available to replace the often-destroyed aortic root, long durability and freedom from reoperation of the latter are still under debate. The aim of our study was to investigate patients' postoperative outcome after implantation of the BioIntegral conduit in complex aortic root pathologies. Methods From February 2014 to May 2017, 33 consecutive patients (69.7% male) with a median age of 73 (57.5; 76.2) years underwent aortic root replacement with the BioIntegral conduit at our institution. Severe aortic valve endocarditis (78.8%) was the predominant indication for surgery. In 28 patients (84.9%), implantation was performed as redo or in 87.8% as urgent and emergent surgery. Primary end-point was the 30-day survival time, evaluated by Cox regression analysis. Secondary midterm outcome and graft-related reoperation were analyzed. Results Median follow-up for all patients was 178 (8; 659) days. Median EuroScore II was 19.9% (13.4; 29.9). Freedom from reoperation was 97%. The overall 30-day mortality rate was 33% mainly caused by multiorgan failure in six (18.2%) patients and cardiac failure in five (15.1%) patients. One further death occurred during follow-up at day 156. None was directly conduit-related. Graft reinfection after the 4th surgery with basal abscess formation occurred in only one patient (3%). Early echocardiographic assessment of the valve revealed good functional results. A higher EuroScore II was significantly associated with a poorer 30-day survival time (hazard ratio, 1.039; 95% confidence interval, 1.015–1.063, p = 0.001). Conclusion Aortic root replacement for complex pathologies is associated with substantial 30-day mortality, but survival of patients after discharge from hospital was stable. Early functional status of the BioIntegral valve was good. Though freedom from re-operation was low, long-term outcome and long-term functional status have to be further evaluated.

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Section: Discussionsupporting

confidence: 72%

Outcomes of Patients after Implantation of the Pericardial All-Biological Valve No-React Aortic Conduit (BioIntegral) for Root Replacement in Complex Surgical Procedures

Puehler

Freitag‐Wolf

Friedrich

et al. 2019

Thorac Cardiovasc Surg

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“…The complete biologic conduit was declared as having better resistance to infection and an alternative to homografts, especially for implantation in patients with endocarditis. 11,12 Despite these suggestions, there is still some doubt. The reluctance about using them is related to a rare risk of infection with a high mortality rate and graft failure with restenosis.…”

Section: Discussionmentioning

confidence: 99%

“…(IQR = 5-17) days in all patients. However, in patients with fever, the median postoperative length of hospital stay was 14 (IQR =[8][9][10][11][12][13][14][15][16][17][18][19][20][21]…”

mentioning

confidence: 99%

High incidence of fever in patients after biointegral pulmonic valved conduit implantation

Selçuk

Kılıç

Korun

et al. 2021

Journal of Cardiac Surgery

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Objective To describe our short‐ and medium‐term outcomes using the BioIntegral pulmonic conduit. Methods Between August 2018 and September 2019, the BioIntegral pulmonic valved conduit was used for right ventricular outflow tract reconstruction in 48 patients. The data were retrospectively retrieved from the patient charts. Results The median age at surgery was 36 months (interquartile range [IQR] = 18–62 months). The diagnoses were pulmonary atresia‐ventricular septal defect in 28 patients, absent pulmonary valve in four patients, truncus arteriosus in six patients, TGA‐VSD‐PS in five patients, conduit stenosis in three patients, and left venticular outflow tract obstruction requiring a Ross operation in two patients. In the postoperative short‐term follow‐up, 15 patients out of 48 had a high fever. Of these, 12 patients had concomitantly elevated C‐reactive protein levels. There were no patients with blood culture positivity. The median postoperative length of hospital stay was 14 days (IQR = 8–21 days). The overall mortality was 4% in two patients, one died of right ventricular failure and multiple organ failure and one died of pulmonary embolism. The two patients who died were not among the 15 patients with fever. However, four patients with fever underwent balloon angioplasty for conduit restenosis in their medium‐term follow‐up. Conclusion There was a high incidence of fever and adverse outcomes in the short‐term postoperative follow‐up of patients in whom the BioIntegral pulmonic valved conduit was implanted. Caution is advisable in using these conduits until there is convincing evidence about the sterilization and storage standards of these grafts.

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“…There are other options available that would allow a biologic replacement of the aortic root, namely, the BioIntegral Bioconduit (BioIntegral Surgical Inc, Mississauga, Canada), 6 the Medtronic Freestyle prosthesis (Medtronic, Flagstaff, AZ), 7 or a homograft. With our technique, the proximal anastomosis can be created with the pericardial tube everted into the left ventricle.…”

Section: Commentmentioning

confidence: 99%

An Alternative Approach to Build a “Biologic Bentall” From a Pericardial Tube and a Sutureless Valve

Krombholz-Reindl

Winkler

Steindl

et al. 2020

The Annals of Thoracic Surgery

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Comparison of mid-term haemodynamic performance between the BioValsalva and the BioIntegral valved conduits after aortic root replacement

Abstract: The present small single-centre study is one of the first to evaluate and compare the BioValsalva and BioIntegral biological aortic-valved conduit in the aortic root position. Both conduits showed optimal haemodynamic results with a low incidence of aortic regurgitation.

Cited by 13 publications

References 13 publications

Outcomes of Patients after Implantation of the Pericardial All-Biological Valve No-React Aortic Conduit (BioIntegral) for Root Replacement in Complex Surgical Procedures

Outcomes of Patients after Implantation of the Pericardial All-Biological Valve No-React Aortic Conduit (BioIntegral) for Root Replacement in Complex Surgical Procedures

High incidence of fever in patients after biointegral pulmonic valved conduit implantation

An Alternative Approach to Build a “Biologic Bentall” From a Pericardial Tube and a Sutureless Valve

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