Month: January 2025

Interdiscip Cardiovasc Thorac Surg. 2024 Dec 3;39(6):ivae194. doi: 10.1093/icvts/ivae194.

ABSTRACT

OBJECTIVES: This study compared the mid-term patency of expanded polytetrafluoroethylene grafts without rings versus that of bovine pericardial conduits used for superior vena cava reconstruction for various thoracic diseases.

METHODS: Among 80 patients who underwent superior vena cava resection and reconstruction between 2009 and 2023 at our institution, 31 patients who received polytetrafluoroethylene grafts without rings (Polytetrafluoroethylene group) and 28 patients who received bovine pericardial conduits (Bovine group) were enrolled. Median follow-up durations were 19.5 and 64.6 months in the Polytetrafluoroethylene and Bovine groups, respectively. Primary outcome was midterm graft patency rate, and secondary outcomes were early and midterm clinical outcomes, including all-cause mortality and superior vena cava reintervention.

RESULTS: Operative mortality was 1.7%. Cumulative incidence of all-cause mortality was not significantly different between the groups. Graft occlusion was detected in 22 patients. Cumulative incidence of graft occlusion was 24.2%, 36.4%, 42.4%, 48.5% and 60.6% at 1 month, 3 months, 6 months, 1 year and 2 years, respectively, in the Bovine group, whereas no graft occlusion was observed in the Polytetrafluoroethylene group (P = 0.007). Although the incidence of graft occlusion was higher in the Bovine group, cumulative incidence of reintervention was not significantly different between the groups (0.0% vs 3.0% in Polytetrafluoroethylene vs Bovine groups at 1 year, P = 0.406). Multivariate analysis demonstrated that bovine pericardial conduit (polytetrafluoroethylene graft as reference) and left brachiocephalic vein reconstruction (right brachiocephalic vein reconstruction as reference) were significant risk factors for graft occlusion.

CONCLUSIONS: In superior vena cava reconstruction, polytetrafluoroethylene grafts without rings were superior to bovine pericardial conduits in terms of midterm graft patency.

PMID:39589858 | DOI:10.1093/icvts/ivae194

Thorac Cardiovasc Surg Rep. 2024 Nov 8;13(1):e29-e32. doi: 10.1055/a-2426-9423. eCollection 2024 Jan.

ABSTRACT

Surgery for Bentall’s endocarditis poses challenges because the infection spreads to the aortic valve annulus, leading to an annular abscess that necessitates reconstruction. We present a straightforward miniskirt Bentall procedure using an annular pericardial patch to treat Bentall’s endocarditis with an annular abscess. After removing the former composite graft and debriding the aortic root and annulus, we created a miniskirt-composite graft using a mechanical or bioprosthetic valve, a straight or Valsalva graft, and an annular bovine pericardial patch with a valve prosthetic sizer. The miniskirt-composite graft, along with the underlying annular pericardial patch, was implanted using a double-layered suture technique.

PMID:39525289 | PMC:PMC11548989 | DOI:10.1055/a-2426-9423