SINGLE-CENTER EXPERIENCE WITH BIOINTEGRAL NO-REACT VALVED CONDUIT FOR THE TREATMENT OF COMPLEX AORTIC ROOT ENDOCARDITIS

Objective: Despite medical and surgical advancements, managing endocarditis involving the aortic root remains challenging for cardiac surgeons due to the anatomical complexity and critical function of the aortic root. This study aims to assess the outcomes of using Biointegral conduit in patients who have undergone aortic root or aortic valve replacement for complex aortic root infective endocarditis at our center. Methods: Between February 2011 and December 2023, 46 patients underwent implantation of BioIntegral valved conduit at our institution. The average age of the patients was 67.6 years, with the primary indication for surgery being severe active endocarditis of the aortic root. We analyzed 30-day mortality, overall survival, and freedom from reoperation as outcome measures using various statistical methods such as T-tests, chi-square tests, Cox regression, and Kaplan-Meier analyses. Results: Out of the 46 patients, six died during their hospital stay (13.0%), resulting in a 30- day mortality rate of 8.2% (four patients). The Cox regression analysis showed that factors such as EUROSCORE II, older age, and CPB time were associated with increased 30-day mortality. The Kaplan-Meier analysis revealed overall survival rates of 87.0% at 1 year and 74.5% at 5 years, while the freedom from reoperation for graft dysfunction was 100% at 1 year and 96.4% at 5 years. Conclusion: Despite the small sample size, our findings suggest positive long-term survival outcomes and low reoperation rates with the use of the BioIntegral conduit. This conduit showed promise even in patients with complex surgical histories and severe aortic root and valve endocarditis.