Bioprosthetic replacement of the ascending thoracic aorta: what are the options?

• Published in: European journal of cardio-thoracic surgery Vol. 35; no. 1; pp. 77 - 82
• Main Authors: Kirsch, Matthias E.W., Ooka, Tomonori, Zannis, Kostantinos, Deux, Jean-François, Loisance, Daniel Y.
• Format: Journal Article
• Language: English
• Published: Oxford Elsevier Science B.V 01-01-2009; Oxford University Press
• Subjects: Aorta - surgery; Aortic root replacement; Aortic Valve - surgery; Bentall procedure; Biological and medical sciences; Bioprosthesis; Blood Vessel Prosthesis; Blood Vessel Prosthesis Implantation - methods; Cardiology. Vascular system; Heart Valve Prosthesis; Heart Valve Prosthesis Implantation - methods; Humans; Medical sciences; Pneumology; Stentless valve; Stents; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Surgery of the heart; Aortic root replacement; Bioprosthesis; Stentless valve; Bentall procedure; Ascending aorta; Root; Replacement; Thoracic aorta; Procedure; Valve; Circulatory system; Cardiology; Pneumology
• ISSN: 1010-7940; 1873-734X
• DOI: 10.1016/j.ejcts.2008.09.011

Increasing patient age and improved durability of latest generation bioprostheses have stimulated the use of bioprosthetic devices in the setting of ascending aortic replacement as an alternative to mechanical valved conduits or aortic valve-sparing procedures. We performed an English literature review to assess different surgical options that have been described for bioprosthetic replacement of the ascending aorta. Reported options include: (1) composite valved conduits using a stented bioprosthesis; (2) composite valved conduits using a stentless bioprosthesis; (3) total xenopericardial valved conduits. Composite valved grafts using stented bioprostheses offer a safe and durable option for bioprosthetic replacement of the ascending aorta. Other options are of more recent use and await medium-term results.