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
OBJECTIVE: We report the combined early results from two centers in the United Kingdom using a composite conduit consisting of a bileaflet mechanical valve incorporated into a 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 the Carbo-Seal composite prosthesis. The indication for surgery was acute type A dissection in 31 (22%), chronic type A dissection in 9 (6%), ascending aortic aneurysm without dissection in 100 (70%), and false aneurysm of the ascending aorta in 3 (2%). Twenty-seven patients (19%) had undergone previous sternotomy, and 40 (28%) were seen as emergencies. Concomitant procedures were performed in 38 (27%), including 18 aortic arch or hemiarch replacements. Total follow-up is 270 patient-years. Follow-up is 100% complete.
RESULTS: The early (30-day) mortality was 7% (10 patients). Permanent neurologic events occurred in 2%. At a mean follow-up of 23 months, 94% of survivors were in New York Heart Association functional class I. Freedom from reoperation was 97.2% +/- 1.6% (1 standard error [1 SE]) at 12 months and 95.7% +/- 2.2% at 48 months. Including early mortality, survival was 90.1% +/- 2.6% at 12 months and 83.1% +/- 3. 5% at 48 months.
CONCLUSIONS: Aortic root replacement with use of the Carbo-Seal prosthesis can be undertaken with a relatively low early mortality and morbidity. A low reoperation rate and high intermediate-term survival can be expected, but continued follow-up is needed to determine the long-term efficacy of this prosthesis.
| Medienart: |
Artikel |
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| Erscheinungsjahr: |
1999 |
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| Erschienen: |
1999 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:118 |
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| Enthalten in: |
The Journal of thoracic and cardiovascular surgery - 118(1999), 6 vom: 14. Dez., Seite 1014-20 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Langley, S M [VerfasserIn] |
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| Themen: |
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| Anmerkungen: |
Date Completed 23.12.1999 Date Revised 07.12.2022 published: Print Citation Status MEDLINE |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM10525763X |
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| 100 | 1 | |a Langley, S M |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Replacement of the proximal aorta and aortic valve using a composite bileaflet prosthesis and gelatin-impregnated polyester graft (Carbo-Seal) |b early results in 143 patients |
| 264 | 1 | |c 1999 | |
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| 500 | |a Date Completed 23.12.1999 | ||
| 500 | |a Date Revised 07.12.2022 | ||
| 500 | |a published: Print | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a OBJECTIVE: We report the combined early results from two centers in the United Kingdom using a composite conduit consisting of a bileaflet mechanical valve incorporated into a gelatin-impregnated, ultra-low porosity, woven polyester graft (Carbo-Seal; Sulzer Carbomedics, Inc, Austin, Tex) | ||
| 520 | |a METHODS: Between August 1992 and March 1997, 143 patients underwent aortic root replacement with the Carbo-Seal composite prosthesis. The indication for surgery was acute type A dissection in 31 (22%), chronic type A dissection in 9 (6%), ascending aortic aneurysm without dissection in 100 (70%), and false aneurysm of the ascending aorta in 3 (2%). Twenty-seven patients (19%) had undergone previous sternotomy, and 40 (28%) were seen as emergencies. Concomitant procedures were performed in 38 (27%), including 18 aortic arch or hemiarch replacements. Total follow-up is 270 patient-years. Follow-up is 100% complete | ||
| 520 | |a RESULTS: The early (30-day) mortality was 7% (10 patients). Permanent neurologic events occurred in 2%. At a mean follow-up of 23 months, 94% of survivors were in New York Heart Association functional class I. Freedom from reoperation was 97.2% +/- 1.6% (1 standard error [1 SE]) at 12 months and 95.7% +/- 2.2% at 48 months. Including early mortality, survival was 90.1% +/- 2.6% at 12 months and 83.1% +/- 3. 5% at 48 months | ||
| 520 | |a CONCLUSIONS: Aortic root replacement with use of the Carbo-Seal prosthesis can be undertaken with a relatively low early mortality and morbidity. A low reoperation rate and high intermediate-term survival can be expected, but continued follow-up is needed to determine the long-term efficacy of this prosthesis | ||
| 650 | 4 | |a Journal Article | |
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| 650 | 7 | |a Gelatin |2 NLM | |
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| 700 | 1 | |a Rooney, S J |e verfasserin |4 aut | |
| 700 | 1 | |a Dalrymple-Hay, M J |e verfasserin |4 aut | |
| 700 | 1 | |a Spencer, J M |e verfasserin |4 aut | |
| 700 | 1 | |a Lewis, M E |e verfasserin |4 aut | |
| 700 | 1 | |a Pagano, D |e verfasserin |4 aut | |
| 700 | 1 | |a Asif, M |e verfasserin |4 aut | |
| 700 | 1 | |a Goddard, J R |e verfasserin |4 aut | |
| 700 | 1 | |a Tsang, V T |e verfasserin |4 aut | |
| 700 | 1 | |a Lamb, R K |e verfasserin |4 aut | |
| 700 | 1 | |a Monro, J L |e verfasserin |4 aut | |
| 700 | 1 | |a Livesey, S A |e verfasserin |4 aut | |
| 700 | 1 | |a Bonser, R S |e verfasserin |4 aut | |
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