Vol 58, No 1 (2003)
Other
Published online: 2005-12-12
Submitted: 2012-12-28
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Early experience with shelhigh stentless composite valve. A complete biological replacement of ascending aorta

Adam Szafranek, Ruchan Akar, Marek Jasiński, Stanisław Woś, Andrzej Sosnowski
Kardiol Pol 2003;58(1):37-38.
Vol 58, No 1 (2003)
Other
Published online: 2005-12-12
Submitted: 2012-12-28

Abstract

Background: Currently, Shelhigh Stentless Composite Valve (SSCV) is the only complete biological conduit available on the market for this purpose. SSCV has been used to avoid anticoagulation with the advantage of established haemodynamic benefits of stentless valves as well as for its surgeon-friendly surgical implantation.
Methods: Between August 1999 and January 2001, 11 patients (8 women, 3 men, mean age 71.5±9.3 years) underwent first time aortic root and ascending aorta replacement with SSCV in Leicester. Aortic regurgitation was found in seven patients and aortic stenosis was predominant in three. Mean preoperative NYHA functional class was 24±0.7 and mean Parsonnet score was 25.1±1.1. Mean preoperative aortic root diameter was 5.34±1.2 cm, left ventricular (LV) end-systolic diameter was 4.3±0.5, and end-diastolic diameter was 6.5±0.6 cm. Preoperative LV ejection fraction was less than 30% in 6 (55%) patients. One patient had additional aortic arch replacement and three patients had concomitant myocardial revascularisation. Seven patients received size 25 mm SSVC, and four patients received size 27 mm SSCV. All patients had Doppler echocardiographic studies before discharge from the hospital and current follow-up data are available for all patients.
Results: All patients survived the early postoperative period, however, one patient developed transient stroke. While no biological glue or teflon were used during surgery, no patient required re-operation for bleeding and there was no significant blood loss recorded postoperatively. Mean postoperative intensive care stay was 1.5±0.7 and hospital stay was 11.3±4.9 days. Postoperative mean gradients were 9.7±3.05 mmHg for 25 mm grafts, and 8.6±4.3 mmHg for 27 mm composite grafts.
Conclusions: Early experience with the SSCV used for the replacement of ascending aorta is encouraging. Practical benefits include improved haemostatic suture line, established haemodynamic advantages of a stentless valve and surgeon-friendly implantation while avoiding long-term anticoagulation.

Abstract

Background: Currently, Shelhigh Stentless Composite Valve (SSCV) is the only complete biological conduit available on the market for this purpose. SSCV has been used to avoid anticoagulation with the advantage of established haemodynamic benefits of stentless valves as well as for its surgeon-friendly surgical implantation.
Methods: Between August 1999 and January 2001, 11 patients (8 women, 3 men, mean age 71.5±9.3 years) underwent first time aortic root and ascending aorta replacement with SSCV in Leicester. Aortic regurgitation was found in seven patients and aortic stenosis was predominant in three. Mean preoperative NYHA functional class was 24±0.7 and mean Parsonnet score was 25.1±1.1. Mean preoperative aortic root diameter was 5.34±1.2 cm, left ventricular (LV) end-systolic diameter was 4.3±0.5, and end-diastolic diameter was 6.5±0.6 cm. Preoperative LV ejection fraction was less than 30% in 6 (55%) patients. One patient had additional aortic arch replacement and three patients had concomitant myocardial revascularisation. Seven patients received size 25 mm SSVC, and four patients received size 27 mm SSCV. All patients had Doppler echocardiographic studies before discharge from the hospital and current follow-up data are available for all patients.
Results: All patients survived the early postoperative period, however, one patient developed transient stroke. While no biological glue or teflon were used during surgery, no patient required re-operation for bleeding and there was no significant blood loss recorded postoperatively. Mean postoperative intensive care stay was 1.5±0.7 and hospital stay was 11.3±4.9 days. Postoperative mean gradients were 9.7±3.05 mmHg for 25 mm grafts, and 8.6±4.3 mmHg for 27 mm composite grafts.
Conclusions: Early experience with the SSCV used for the replacement of ascending aorta is encouraging. Practical benefits include improved haemostatic suture line, established haemodynamic advantages of a stentless valve and surgeon-friendly implantation while avoiding long-term anticoagulation.
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Keywords

replacement of ascending aorta - shelhigh stentless composite valve

About this article
Title

Early experience with shelhigh stentless composite valve. A complete biological replacement of ascending aorta

Journal

Kardiologia Polska (Polish Heart Journal)

Issue

Vol 58, No 1 (2003)

Pages

37-38

Published online

2005-12-12

Bibliographic record

Kardiol Pol 2003;58(1):37-38.

Keywords

replacement of ascending aorta - shelhigh stentless composite valve

Authors

Adam Szafranek
Ruchan Akar
Marek Jasiński
Stanisław Woś
Andrzej Sosnowski

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