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Thoracic Aortic Research Program University of Pennsylvania School of Medicine Philadelphia, PA

Hemodynamic PERFORMANCE of Biologic Root Replacements: Pericardial Composite v . Porcine Bioroots. Nimesh Desai MD, Fenton McCarthy, Wilson Szeto MD, Alberto Pochettino MD, Richard Erwin, Yasmin El- Sayed , Joseph Bavaria MD. Thoracic Aortic Research Program

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Thoracic Aortic Research Program University of Pennsylvania School of Medicine Philadelphia, PA

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  1. Hemodynamic PERFORMANCE of Biologic Root Replacements: Pericardial Composite v. Porcine Bioroots Nimesh Desai MD, Fenton McCarthy, Wilson Szeto MD, Alberto Pochettino MD, Richard Erwin, Yasmin El-Sayed, Joseph Bavaria MD Thoracic Aortic Research Program University of Pennsylvania School of Medicine Philadelphia, PA

  2. OBJECTIVES • Stentless porcine bioroots were developed as a root replacement that avoids anticoagulation • Concerns have been raised about porcine bioroots • Early structural valve deterioration • Increased complexity of reoperation • Renewed interest in pericardial valved composite roots • This study evaluates the hemodynamics of porcine bioroots and pericardial composite roots

  3. Methods • Evaluated all patients receiving either a porcine bioroot (St. Jude Toronto Root) or a pericardial composite root (CE pericardial model 2800 + dacron graft) • Single institution from December 2001-June 2009 • All root replacements performed for root pathology • Preoperative, postoperative and greater than one year follow-up echo data was compiled for all patients. • Median follow-up 3.0 years (range 1yr-6.5 yrs) • Patients with endocarditis or acute aortic dissections were excluded

  4. Indications for Root Replacement *Chronic Dissection **Dehisced AVRs [3], chronic dissection [1]

  5. Results Preop PREOPEREATIVELY : NO significant differences between the groups

  6. Results Postop POSTOPERATIVELY : NO significant differences between the groups

  7. Results > 1 Year

  8. Valve Size

  9. Conclusion • Porcine bioroots have lower gradients at greater than one year of follow-up • Gradients were low in both groups overall • Similar left ventricular remodeling as assessed by LV mass regression and LV diameters • Suggests pericardial roots are a viable alternative

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