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Abstract
Objective: We are presenting a conceptually new approach involving the use of a self-made xeno-pericardial graft in combination with biological aortic valve prosthesis in patients with prosthetic endocarditis. Method: In case of proven prosthetic infective endocarditis after aortic root replacement our strategy includes complete explantation of the infected vascular prosthesis and valve, forming a new vascular tube from bovine pericardium corresponding to the dimensions of the aortic annulus and ascending aorta and sewing a new biological valve into it. The procedure was performed under short circulatory arrest with unilateral brain perfusion in mild hypothermia. Results: During surgery the aortic root, ascending aorta and hemiarch were replaced using a xenopericardial valved graft. The length of the stay in ICU and general ward was 24 days. No early and late neurological deficits were found. Follow Up time was 6 months. The course of antibiotic therapy was completed in 6 weeks. At the follow up no signs of repeated infection as well as structural changes of the valve were found. Conclusions: Implantation of self-made xenopericardial valved graft is an innovative strategy and represents a safe alternative for prosthetic infective endocarditis. The short-term results of this approach are excellent, although further studies are needed to confirm positive medium and long-term results in large cohorts. Self-made valved xenopericardial grafts are readily available, off the-shelf, easy to assemble and durable alternative for the replacement of all aortic segments from the root till arch.
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