Bentall Procedure With The Carboseal (Tm) And Carboseal Valsalva (Tm) Composite Conduits: Long-Term Outcomes

OBJECTIVES: Data on the long-term results with the standard CarboSeal (TM) mechanical conduit used for the modified Bentall procedure are lacking as well as information on performance of the Valsalva CarboSeal (TM) conduit.METHODS: We have analysed 208 recipients of a standard (n = 110) or a Valsalva (n = 98) CarboSeal (TM) conduit. The median age was 60 years and 90% were males; 35 (17%) had type A aortic dissection and 65 (30%) a bicuspid aortic valve. Data were retrospectively analysed and results were compared between the 2 conduit models.RESULTS: Early mortality was 1.9%; the mean follow-up was 175 +/- 95 for standard and 94 +/- 51 months for Valsalva conduits (P < 0.01). Actuarial survival was 86 +/- 4%, 75 +/- 6%, 59 +/- 7% and 51 +/- 9% at 5, 10, 15 and 20 years, respectively. There were 13 thromboembolic episodes with 3 deaths with an actuarial freedom of 98 +/- 1%, 94 +/- 2%, 90 +/- 3% and 89 +/- 4% at 5, 10, 15 and 20 years, respectively. Reoperation on the aortic root was performed in 9 patients for endocarditis (n = 8) and pseudoaneurysm at the right coronary button (n = 1) with an actuarial freedom of 97 +/- 1%, 95 +/- 2%, 92 +/- 3% and 87 +/- 4% at 5, 10, 15 and 20 years, respectively. There were no differences between the 2 conduit models in survival and major postoperative complications.CONCLUSIONS: The CarboSeal (TM) conduit has shown gratifying overall performance up to 20 years and appears a valid option for a modified Bentall operation, when a mechanical prosthesis is indicated. Both CarboSeal (TM) conduit models provided not statistically different overall long-term results.