Premium
Use of the Medtronic Freestyle for aortic valve infection: A retrospective propensity score matched analysis
Author(s) -
Easo Jerry,
Szczechowicz Marcin,
Hoelzl Philipp,
Horst Michael,
Eichstaedt Harald,
Zhigalov Konstantin,
Mashhour Ahmed,
Weymann Alexander,
Dapunt Otto E.
Publication year - 2019
Publication title -
journal of cardiac surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.428
H-Index - 58
eISSN - 1540-8191
pISSN - 0886-0440
DOI - 10.1111/jocs.14176
Subject(s) - medicine , propensity score matching , cohort , endocarditis , logistic regression , proportional hazards model , aortic valve , retrospective cohort study , surgery , cardiology
Backgrounds Aortic valve and prosthetic valve endocarditis present a challenging subgroup of patients at high risk. We analyzed our experience using the Medtronic Freestyle in full root technique for the treatment of these cases over 18‐year time period. Methods We investigated the endocarditis subgroup from our cohort of 971 patients and compared results against other valve types with propensity score matching implementing nearest neighbor method. T ‐test, χ 2 test, logistic regression, and Cox regression were performed. Results Fifty‐four patients from the Freestyle group (FS) were matched against 54 patients from a cohort of 376 aortic valve/root endocarditis patients treated by other valve types (non‐FS). Hospital mortality was 9/54 (16.7%) in the FS vs 13/54 (24.1%) in the non‐FS group ( P = .33). Variables age ( P = .003) and renal impairment ( P = .026) had an impact on mortality according to Cox regression analysis for early results. Variables with significant risk for long‐term mortality included postoperative renal impairment ( P = .0001) and multiorgan failure ( P = .0001). Recurrent infection was low (1.8% for FS and 3.7% for non‐FS group), and freedom from reoperation was 97.2%. Use of the Medtronic Freestyle was no significant risk factor for long‐term mortality. Conclusion The Freestyle stentless xenograft is a viable alternative for treatment of valve/root and prosthetic endocarditis. In our experience, it showed good postoperative performance with low rate of reinfection while having an acceptable operative risk‐profile for this high‐risk cohort.