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

Hanna H. Dagnegård, Kirstine Bekke, Solveig M. Kolseth, Natalie Glaser, Christoffer Wallén, Ismail El-Hamamsy, Kristjan O. Vidisson, Asbjørn S. Lie, Jan B. Valentin, Ulrik Sartipy, Rune Haaverstad, Farkas Vanky, Laurence Lefebvre, Tomas Gudbjartsson, Søren P. Johnsen, Lars Søndergaard, Gustav H. Thyregod, Jens T. Lund, Nikolaj Ihlemann, Morten H. Smerup

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2 Citations (Scopus)


ABSTRACT Objectives Our objective was to examine intermediate-term survival and reinterventions in unselected patients, stratified by indication, who received a Freestyle® 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 six North-Atlantic centers. Survival status was extracted from national registries and results stratified for 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 non-elective cases and 34.0% were reoperations. Median age was 66.0 years (IQR 58.0-71.8) and median follow-up was 5.0 years (IQR 2.6-7.9). 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 by age and sex (p-values 0.95, 0.83 and 0.16 for aneurysms, small roots and other, respectively). In contrast, patients with endocarditis and type A dissection had excess mortality (p-values
Original languageEnglish
JournalThe Journal of Thoracic and Cardiovascular Surgery
Publication statusE-pub ahead of print - 2021


  • aortic root replacement
  • endocarditis
  • full root bioprosthesis
  • reinterventions
  • survival
  • type A dissections


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