Long‐term follow‐up after Bentall operation using a stentless Shelhigh NR‐2000 bio‐conduit

Abstract

Background To analyze the long‐term results after Bentall operation using the stentless Shelhigh No‐React (NR)‐2000 bio‐root prosthesis. Material From 2004 to 2008, 26 consecutive, nonselected patients (mean age at surgery: 67 ± 9 years) underwent a Bentall operation using a stentless Shelhigh valved conduit at our institution. Mean preoperative Logistic‐EuroSCORE was 17.1 ± 12.9. The mean size of the aortic root was 53.2 ± 5 mm. The mean preoperative ejection fraction was 55 ± 7.4%. Three patients had a bicuspid valve. One patient with acute endocarditis and one patient with type A aortic dissection were operated on an emergency. Three patients (11.54%) had a previous cardiac operation. The Button‐Bentall technique was used in all cases. Seven patients (26.92%) received an associated procedure. The mean size of the implanted prosthesis was 26.1 ± 2.2. Follow‐up ranged between 6 and 174 months (mean 93.4 ± 59.1 months). Primary endpoints consisted of early and late mortality, freedom from acute endocarditis, freedom from structural valve deterioration, and freedom from valve‐related‐reoperation. Results Two patients died in hospital, while 10 patients died during follow‐up time, of which three for cardiac causes (12.5%). Overall survival probability was 52.9% at 15 years. Freedom from acute endocarditis was 95.7% at 5 and 15 years. Freedom from severe aortic incompetence due to structural deterioration was 100% at 5 and 10 years, 90.9% at 15 years. The mean aortic gradient at follow‐up was 11.4 ± 5 mm Hg. Freedom from valve‐related reoperation was 100% at 5 and 10 years, 90.9% at 15 years. Conclusions In our experience, Bentall's operation using the Shelhigh NR‐2000 stentless bio‐conduit provided satisfactory early and long‐term results. However, our findings are not consistent with unfavorable long‐term outcomes following the implantation of this device reported by other authors.