Replacement of the ascending aorta and aortic valve for Annuloaortic ectasia with Carbomedics Carbo-seal ValsalvaTM graft: mid- to long-term results

Purpose The modified Bentall procedure (MBP) employing the Carbomedics Carbo-seal Valsalva™ graft may be used to treat patients with annuloaortic ectasia. In this study we focused on patients who underwent MBP to treat annuloaortic ectasia. Our goal was to review the outcomes of these surgeries over a long period. Methods From 2012 to 2024 48 consecutive patients with annuloaortic ectasia underwent aortic root replacement with Carbomedics Carbo-seal Valsalva™ graft. Concomitant cardiac procedures were performed in 7 patients (MBP+Mitral valve annuloplasty, 2 patients and MBP+Coronary artery bypass grafting, 5 patients). Mean Cardiopulmonary bypass and aortic clamp time for were 151±37 and 128±14 minutes, respectively. Results The operative mortality was 2.1% (n = 1). Late causes of death were chronic heart failure (1 patient, 2.1%), cerebral haemorrhage (1 patient, 2.1%) and pulmonary complications (1 patient, 2.1%). And major late complications included cerebral hemorrhage in 2 patients (4.2%), cerebellar ischemia in 1 patient (2.1%) and gastrointestinal hemorrhage in 2 patient (4.2%). Kaplan-Meier estimated survival rates for 5 and 10 years were 96.22% and 95.20% respectively. The Kaplan-Meier curves showed event-free survival at 5 and 12 years 98% and 82%, respectively (CI 95%). Conclusions MBP operations for annuloaortic ectasia, with Carbomedics Carbo-seal Valsalva™ graft, can be performed with a low mid- and long-term mortality and morbidity in low-volume centers.