Universität zu Köln

Easo, Jerry, Weymann, Alexander, Hoelzl, Philipp, Horst, Michael, Eichstaedt, Harald, Mashhour, Ahmed, Zhigalov, Konstantin ORCID: 0000-0002-6440-3736, Szczechowicz, Marcin, Thomas, Rohit Philip, Sabashnikov, Anton and Dapunt, Otto E. (2019). Hospital Results of a Single Center Database for Stentless Xenograft Use in a Full Root Technique in Over 970 Patients. Sci Rep, 9. LONDON: NATURE PUBLISHING GROUP. ISSN 2045-2322

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Abstract

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 allcomers 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.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Easo, Jerry UNSPECIFIED UNSPECIFIED UNSPECIFIED Weymann, Alexander UNSPECIFIED UNSPECIFIED UNSPECIFIED Hoelzl, Philipp UNSPECIFIED UNSPECIFIED UNSPECIFIED Horst, Michael UNSPECIFIED UNSPECIFIED UNSPECIFIED Eichstaedt, Harald UNSPECIFIED UNSPECIFIED UNSPECIFIED Mashhour, Ahmed UNSPECIFIED UNSPECIFIED UNSPECIFIED Zhigalov, Konstantin UNSPECIFIED orcid.org/0000-0002-6440-3736 UNSPECIFIED Szczechowicz, Marcin UNSPECIFIED UNSPECIFIED UNSPECIFIED Thomas, Rohit Philip UNSPECIFIED UNSPECIFIED UNSPECIFIED Sabashnikov, Anton UNSPECIFIED UNSPECIFIED UNSPECIFIED Dapunt, Otto E. UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-153859
DOI:	10.1038/s41598-019-40772-7
Journal or Publication Title:	Sci Rep
Volume:	9
Date:	2019
Publisher:	NATURE PUBLISHING GROUP
Place of Publication:	LONDON
ISSN:	2045-2322
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language AORTIC ROOT; VALVE-REPLACEMENT; BIOPROSTHESIS; EXPERIENCE; SURGERY; RISK Multiple languages Multidisciplinary Sciences Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/15385