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Survival after aortic root replacement with a stentless xenograft is determined by patient characteristics

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dc.contributor Landspitali - The National University Hospital of Iceland
dc.contributor.author Dagnegård, Hanna H.
dc.contributor.author Bekke, Kirstine
dc.contributor.author Kolseth, Solveig M.
dc.contributor.author Glaser, Natalie
dc.contributor.author Wallén, Christoffer
dc.contributor.author El-Hamamsy, Ismail
dc.contributor.author Víðisson, Kristján O.
dc.contributor.author Lie, Asbjørn S.
dc.contributor.author Valentin, Jan B.
dc.contributor.author Sartipy, Ulrik
dc.contributor.author Haaverstad, Rune
dc.contributor.author Vanky, Farkas
dc.contributor.author Lefebvre, Laurence
dc.contributor.author Guðbjartsson, Tómas
dc.contributor.author Johnsen, Søren P.
dc.contributor.author Søndergaard, Lars
dc.contributor.author Thyregod, Gustav H.
dc.contributor.author Lund, Jens T.
dc.contributor.author Ihlemann, Nikolaj
dc.contributor.author Smerup, Morten H.
dc.date.accessioned 2023-03-28T01:03:12Z
dc.date.available 2023-03-28T01:03:12Z
dc.date.issued 2021
dc.identifier.citation Dagnegård , H H , Bekke , K , Kolseth , S M , Glaser , N , Wallén , C , El-Hamamsy , I , Víðisson , K O , Lie , A S , Valentin , J B , Sartipy , U , Haaverstad , R , Vanky , F , Lefebvre , L , Guðbjartsson , T , Johnsen , S P , Søndergaard , L , Thyregod , G H , Lund , J T , Ihlemann , N & Smerup , M H 2021 , ' Survival after aortic root replacement with a stentless xenograft is determined by patient characteristics ' , Journal of Thoracic and Cardiovascular Surgery , vol. 164 , no. 6 , pp. 1712-1724 . https://doi.org/10.1016/j.jtcvs.2021.07.011
dc.identifier.issn 0022-5223
dc.identifier.other 38856527
dc.identifier.other 445c08c4-5346-4f4a-9684-51c336577602
dc.identifier.other 85113240826
dc.identifier.other unpaywall: 10.1016/j.jtcvs.2021.07.011
dc.identifier.uri https://hdl.handle.net/20.500.11815/4099
dc.description Publisher Copyright: © 2021 The Authors
dc.description.abstract Objectives: Our objective was to examine intermediate-term survival and reinterventions in unselected patients, stratified according to indication, who received a Freestyle (Medtronic Inc, Minneapolis, Minn) bioprosthesis as a full aortic root replacement. Methods: Data from medical records were retrospectively collected for patients who had aortic root replacement using Freestyle bioprostheses between 1999 and 2018 at 6 North-Atlantic centers. Survival status was extracted from national registries and results stratified according to indication for surgery. Results: We included 1030 implantations in 1008 patients with elective indications for surgery: aneurysm (39.8%), small root (8.3%), and other (13.8%), and urgent/emergent indications: endocarditis (26.7%) and Stanford type A aortic dissection (11.4%). Across indications, 46.3% were nonelective cases and 34.0% were reoperations. Median age was 66.0 (interquartile range, 58.0-71.8) years and median follow-up was 5.0 (interquartile range, 2.6-7.9) years. Thirty-day mortality varied from 2.9% to 27.4% depending on indication. Intermediate survival for 90-day survivors with elective indications were not different from the general population standardized for age and sex (P = .95, 83, and .16 for aneurysms, small roots, and other, respectively). In contrast, patients with endocarditis and type A dissection had excess mortality (P < .001). Freedom from valve reinterventions was 95.0% and 94.4% at 5 and 8 years, respectively. In all, 52 patients (5.2%) underwent reinterventions, most because of endocarditis. Conclusions: At intermediate term follow-up this retrospective study provides further support for the use of the Freestyle bioprosthesis in the real-world setting of diverse, complex, and often high-risk aortic root replacement and suggests that outcome is determined by patient and disease, rather than by prosthesis, characteristics.
dc.format.extent 13
dc.format.extent 3526350
dc.format.extent 1712-1724
dc.language.iso en
dc.relation.ispartofseries Journal of Thoracic and Cardiovascular Surgery; 164(6)
dc.rights info:eu-repo/semantics/openAccess
dc.subject Hjartasjúkdómar
dc.subject Hjartaþelsbólga
dc.subject Hjarta- og lungnaskurðlæknisfræði
dc.subject aortic root replacement
dc.subject endocarditis
dc.subject full root bioprosthesis
dc.subject reinterventions
dc.subject survival
dc.subject type A dissections
dc.subject Surgery
dc.subject Pulmonary and Respiratory Medicine
dc.subject Cardiology and Cardiovascular Medicine
dc.title Survival after aortic root replacement with a stentless xenograft is determined by patient characteristics
dc.type /dk/atira/pure/researchoutput/researchoutputtypes/contributiontojournal/article
dc.description.version Peer reviewed
dc.identifier.doi 10.1016/j.jtcvs.2021.07.011
dc.relation.url http://www.scopus.com/inward/record.url?scp=85113240826&partnerID=8YFLogxK
dc.contributor.department Faculty of Medicine
dc.contributor.department Cardio-Vascular Center

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