Replacement of the proximal aorta and aortic valve using a composite bileaflet prosthesis and gelatin-impregnated polyester graft (Carbo-Seal): early results in 143 patients.

摘要: Abstract Objective: We report the combined early results from two centers in United Kingdom using a composite conduit consisting of bileaflet mechanical valve incorporated into gelatin-impregnated, ultra-low porosity, woven polyester graft (Carbo-Seal; Sulzer Carbomedics, Inc, Austin, Tex). Methods: Between August 1992 and March 1997, 143 patients underwent aortic root replacement with Carbo-Seal prosthesis. The indication for surgery was acute type A dissection 31 (22%), chronic 9 (6%), ascending aneurysm without 100 (70%), false aorta 3 (2%). Twenty-seven (19%) had undergone previous sternotomy, 40 (28%) were seen as emergencies. Concomitant procedures performed 38 (27%), including 18 arch or hemiarch replacements. Total follow-up is 270 patient-years. Follow-up 100% complete. Results: (30-day) mortality 7% (10 patients). Permanent neurologic events occurred 2%. At mean 23 months, 94% survivors New York Heart Association functional class I. Freedom reoperation 97.2% ± 1.6% (1 standard error [1 SE]) at 12 months 95.7% 2.2% 48 months. Including mortality, survival 90.1% 2.6% 83.1% 3.5% Conclusions: Aortic use prosthesis can be undertaken relatively low morbidity. rate high intermediate-term expected, but continued needed to determine long-term efficacy this (J Thorac Cardiovasc Surg 1999;118:1014-20)