Allograft Root Replacement for Prosthetic Endocarditis
Abstract
A series of 53 root replacements of the aortic valve for severe endocarditis is presented. The principles of this technique are to remove all abscesses and infected areas likely to drain into the mediastinum, excision of infected tissue down to healthy noninfected tissue, and replacement with an antibiotic-impregnated homograft aortic root. Using this technique there has been a very high rate of cure of this most dreaded complication.
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Under conditions of extensive destruction of periannular supporting tissues, human aortic homografts, when available, can be used to replace the damaged aortic valve and to reconstruct the damaged aorta.
“Under these conditions, human aortic homografts, when available, can be used to replace the damaged aortic valve and to reconstruct the damaged aorta.310,311”
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Baddour, L. M., Wilson, W. R., Bayer, A. S., Fowler, V. G., Tleyjeh, I. M., Rybak, M. J., Barsic, B., Lockhart, P. B., Gewitz, M. H., Levison, M. E., et al. (2015) · Circulation · doi:10.1161/cir.0000000000000296 · Cited by 3,232 · see citing works
“Under these conditions, human aortic homografts, when available, can be used to replace the damaged aortic valve and to reconstruct the damaged aorta.(310,311) Homografts have a constant but low incidence rate of IE.”
MethodBaddour, L. M., Wilson, W. R., Bayer, A. S., Fowler, V. G., Bolger, A. F., Levison, M. E., Ferrieri, P., Gerber, M. A., Tani, L. Y., Gewitz, M. H., et al. (2005) · Circulation · doi:10.1161/circulationaha.105.165564 · Cited by 1,707 · see citing works
Diagnosis and Management of Infective Endocarditis and Its Complications
Bayer, A. S., Bolger, A. F., Taubert, K. A., Wilson, W. R., Steckelberg, J. M., Karchmer, A. W., Levison, M. E., Chambers, H. F. “., Dajani, A. S., Gewitz, M. H., et al. (1998) · Circulation · doi:10.1161/01.cir.98.25.2936 · Cited by 745 · see citing works
Glazier, J. J., Verwilghen, J., Donaldson, R. M., & Ross, D. N. (1991) · Journal of the American College of Cardiology · doi:10.1016/0735-1097(91)90851-y · Cited by 144 · see citing works
Self-citationMahesh, B., Angelini, G. D., Caputo, M., Jin, X. Y., & Bryan, A. J. (2005) · The Annals of Thoracic Surgery · doi:10.1016/j.athoracsur.2004.11.001 · Cited by 110 · see citing works
The utility of cardiac MRI in diagnosis of infective endocarditis: preliminary results
Dursun, M., Yılmaz, S., Yılmaz, E., Yılmaz, R., Önür, İ., Oflaz, H., & Dindar, A. (2014) · Diagnostic and Interventional Radiology · doi:10.5152/dir.2014.14239 · Cited by 111 · see citing works
Surgical treatment of endocarditis
Moon, M. R., Stinson, E. B., & Miller, D. C. (1997) · Progress in Cardiovascular Diseases · doi:10.1016/s0033-0620(97)80036-9 · Cited by 95 · see citing works
Determinants of Early Mortality and Late Survival in Mitral Valve Endocarditis
Aranki, S. F., Adams, D. H., Rizzo, R. J., Couper, G. S., Sullivan, T. E., Collins, J. J., & Cohn, L. H. (1995) · Circulation · doi:10.1161/01.cir.92.9.143 · Cited by 71 · see citing works
Nguyen, D. T., Delahaye, F., Obadia, J., et al. (2009) · European Journal of Cardio-Thoracic Surgery · doi:10.1016/j.ejcts.2009.11.035 · Cited by 68 · see citing works
“Use of a homograft allows the surgeon to more effectively reconstruct the aortic root, particularly in the presence of deep abscesses, aortoventricular dehiscence and aortic root distortion [18,19].”
BackgroundTreatment of aortic valve endocarditis with the Ross operation1
Pettersson, G., Tingleff, J., & Joyce, F. (1998) · European Journal of Cardio-Thoracic Surgery · doi:10.1016/s1010-7940(98)00053-0 · Cited by 51 · see citing works
“Standard treatment of patients with infective endocarditis is radical debridement and valve replacement, in cases with advanced pathology the treatment is usually root replacement with either a composite graft [4] or a homograft [5–10].”
BackgroundTransesophageal Echocardiography (TEE) in the Evaluation of Infective Endocarditis
Ryan, E. W., & Bolger, A. F. (2000) · Cardiology Clinics · doi:10.1016/s0733-8651(05)70179-x · Cited by 31 · see citing works
Replacement of the aortic valve with cryopreserved aortic allograft
Doty, D. B., Michielon, G., Wang, N., et al. (1993) · The Annals of Thoracic Surgery · doi:10.1016/0003-4975(93)91152-d · Cited by 29 · see citing works
Pseudoaneurysm following aortic homograft: clinical implications?
Oechslin, E. N., Carrel, T. P., Ritter, M., et al. (1995) · Heart · doi:10.1136/hrt.74.6.645 · Cited by 21 · see citing works
Aortic root replacement with human tissue valves in aortic valve endocarditis
Dossche, K., DELARIVIERE, A., Morshuis, W. J., Schepens, M. A. A. M., & Ernst, J. M. P. G. (1997) · European Journal of Cardio-Thoracic Surgery · doi:10.1016/s1010-7940(97)00145-0 · Cited by 14 · see citing works
Therapy of Acute Aortic Regurgitation
Cohn, L. H., & Birjiniuk, V. (1991) · Cardiology Clinics · doi:10.1016/s0733-8651(18)30306-0 · Cited by 12 · see citing works
Aortic valve replacement using bovine pericardial bioprostheses: 12 years of experience
Braile, D. M., Leal, J. C. F., de Godoy, M. F., et al. (2003) · Brazilian Journal of Cardiovascular Surgery · doi:10.1590/s0102-76382003000300005 · Cited by 10 · see citing works
“Studies using bioprostheses (autograft, homograft and heterograft) gave promising results, in relation to death and the quality of life of patients [9,10].”
ResultAortic root replacement: modifications of technique with improvements in technology
Westaby, S., Parry, A., & Pillai, R. G. (1992) · European Journal of Cardio-Thoracic Surgery · doi:10.1093/ejcts/6.supplement_1.s44 · Cited by 7 · see citing works
Surgical treatment of active infectious endocarditis: a study of 361 surgical cases
Dias, A. R., Pomerantzeff, P. M. A., Brandão, C. M. D. A., et al. (2003) · Brazilian Journal of Cardiovascular Surgery · doi:10.1590/s0102-76382003000200010 · Cited by 6 · see citing works
“In 2 patients with large abscesses there was a discontinuity between the left ventricle and the aorta, which obliged the use of valved tubular grafts and re-implantation of the coronary arteries, the so-called valvar translocation, which was necessary given the intensity of the annular damage observed [10-14].”
BackgroundArena, V., Gerometta, P., Pompilio, G., Zanobini, M., Parolari, A., Antona, C., Polvani, G., Susini, G., & Biglioli, P. (1993) · Cardiovascular Surgery · doi:10.1177/096721099300100423 · Cited by 3 · see citing works
Midterm Results of Aortic Valve Replacement with Cryopreserved Homografts
Vuran, C., Simon, P., Wollenek, G., Özker, E., & Aslım, E. (2011) · Balkan Medical Journal · doi:10.5152/balkanmedj.2011.017 · Cited by 3 · see citing works
“The first surgical conduit option in the treatment of endocarditis is a homograft (6-13).”
BackgroundSymbas, P. N., Justicz, A. G., & Anderson, N. A. (1995) · Cardiovascular Surgery · doi:10.1016/0967-2109(95)93887-u · Cited by 3 · see citing works
Pallasch, J., Takahashi, M., Taubert, K. A., Shulman, S. T., Burns, J. C., Falace, D. A., Newburger, J. W., Gewitz, H.-S., Tong, D., Steckelberg, J. M., et al. (2007) · Cited by 3 · see citing works
MINALE, C., Splittgerber, F. H., & Cramer, B. (1994) · Journal of Thoracic and Cardiovascular Surgery · doi:10.1016/s0022-5223(94)70442-2 · Cited by 3 · see citing works
Prevention and Treatment of Infective Endocarditis
Stancoven, A., & Peterson, G. (2012) · Elsevier eBooks · doi:10.1016/b978-1-4557-0101-8.00043-6 · Cited by 2 · see citing works
Kovuri, P., Kumaran, S. S., & Chatterjee, T. (2022) · Cureus · doi:10.7759/cureus.24189 · Cited by 2 · see citing works
“Aortic homografts are now available to reconstruct the aorta [20].”
BackgroundStentless fresh pulmonary homograft in mitral position.
Renzulli, A., Cerasuolo, F., Festa, M., et al. (1995) · PubMed · Cited by 1 · see citing works
Prevention and Treatment of Endocarditis
Peterson, G., & Cabell, C. H. (2007) · Elsevier eBooks · doi:10.1016/b978-1-4160-3358-5.50050-4
Fullerton, D. A., & Grover, F. L. (2010) · Elsevier eBooks · doi:10.1016/b978-1-4160-5225-8.00081-7
Symbas, P. N., Justicz, A. G., & Anderson, N. A. (1995) · Cardiovascular Surgery · doi:10.1177/096721099500300317
- Authors
- ROSS, D.
- Corresponding author
- ROSS, DONALD
- Venue
- Journal of Cardiac Surgery
- Publisher
- Hindawi Limited
- Published
- 1990-03
- Volume
- 5
- Issue
- 1
- Pages
- 68-72
- ISSN
- 0886-0440 (ISSN-L)
- 1540-8191
- OpenAlex
- W2057672084
- Cited by
- 28
- References
- 0
- Citations by year
- 2022: 1 · 2015: 1 · 2014: 1 · 2012: 1
- FWCI
- 1.86
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Cardiac Surgery (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Epidemiology › Infective Endocarditis Diagnosis and Management
- Health Sciences › Medicine › Surgery › Infectious Aortic and Vascular Conditions
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Valve Diseases and Treatments
- Keywords
- prosthetic valve endocarditis, allograft, mediastinal abscess, prosthetic heart valve complications
- MeSH terms
- Abscess, Adult, Aorta, Aortic Valve, Child, Endocarditis, Bacterial, Heart Valve Prosthesis, Humans, Suppuration, Transplantation, Homologous, Prosthesis-Related Infections
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