Bentall procedure with the CarboSeal™ and CarboSeal Valsalva™ composite conduits: long-term outcomes

OBJECTIVES: Data on the long-term results with the standard CarboSeal mechanical conduit used for the modified Bentall procedure are lacking as well as information on performance of the Valsalva CarboSeal conduit.METHODS: We have analysed 208 recipients of a standard (n=110) or a Valsalva (n=98) CarboSeal conduit. The median age was 60years and 90% were males; 35 (17%) had type A aortic dissection and 65 (30%) a bicuspid aortic valve. Data were retrospectively analysed and results were compared between the 2 conduit models.RESULTS: Early mortality was 1.9%; the mean follow-up was 175±95 for standard and 94±51months for Valsalva conduits (P<0.01). Actuarial survival was 86±4%, 75±6%, 59±7% and 51±9% at 5, 10, 15 and 20years, respectively. There were 13 thromboembolic episodes with 3 deaths with an actuarial freedom of 98±1%, 94±2%, 90±3% and 89±4% at 5, 10, 15 and 20years, respectively. Reoperation on the aortic root was performed in 9 patients for endocarditis (n=8) and pseudoaneurysm at the right coronary button (n=1) with an actuarial freedom of 97±1%, 95±2%, 92±3% and 87±4% at 5, 10, 15 and 20years, respectively. There were no differences between the 2 conduit models in survival and major postoperative complications.CONCLUSIONS: The CarboSeal conduit has shown gratifying overall performance up to 20years and appears a valid option for a modified Bentall operation, when a mechanical prosthesis is indicated. Both CarboSeal conduit models provided not statistically different overall long-term results.