{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,23]],"date-time":"2026-08-23T17:43:26Z","timestamp":1787507006799,"version":"build-2736575974"},"reference-count":28,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2022,4,7]],"date-time":"2022-04-07T00:00:00Z","timestamp":1649289600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,8,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p\/>\n                  <jats:sec>\n                    <jats:title>OBJECTIVES<\/jats:title>\n                    <jats:p>The aim of this study was to evaluate early- and long-term outcomes of cryopreserved aortic homograft (CAH) implantation for aortic valve replacement (AVR) or aortic root replacement (ARR) in patients with or without complex infective endocarditis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>All adult patients undergoing AVR or ARR with CAH at our institution between January 1993 and July 2021 were included in the study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>One hundred four patients, 75 males and 29 females, aged 59 \u00b1 17 years, underwent AVR or ARR with CAH for infective endocarditis (n = 94, 90%) or aortic valve disease (n = 10, 10%). There were 33 (35%) native valve endocarditis and 61 (65%) prosthetic valve endocarditis, which were complicated by annular abscess in 77 (82%) patients, mitral valve endocarditis in 13 (14%) and tricuspid valve endocarditis in 13 (14%). The mean cardiopulmonary bypass time was 214 \u00b1 80 min and the mean aortic cross-clamping time was 164 \u00b1 56 min. There were 12 (12%) hospital deaths and 7 (7%) postoperative low cardiac output syndrome requiring extracorporeal membrane oxygenation in 4 patients and intra-aortic balloon pump in 3. Thirty-nine (42%) patients died during the follow-up (94% complete). The mean survival time was 13.9 \u00b1 1.2 years. Twenty-five patients (26%) underwent late reoperation for aortic homograft degeneration (n = 17, 18%), homograft endocarditis (n = 6, 7%), homograft dehiscence (n = 1, 1%) and mitral valve regurgitation (n = 1, 1%). The mean survival free from reintervention was 15.7 \u00b1 1.2 years.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS<\/jats:title>\n                    <jats:p>AVR or ARR with a CAH for complex endocarditis is associated with satisfactory hospital survival, considering the critical patient presentation at surgery, and excellent survival free from recurrent infection. Need for reoperation late after surgery is similar to other biological prostheses.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ejcts\/ezac193","type":"journal-article","created":{"date-parts":[[2022,3,15]],"date-time":"2022-03-15T16:10:13Z","timestamp":1647360613000},"source":"Crossref","is-referenced-by-count":19,"title":["Cryopreserved aortic homografts for complex aortic valve or root endocarditis: a 28-year experience"],"prefix":"10.1093","volume":"62","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5965-6571","authenticated-orcid":false,"given":"Antonella","family":"Galeone","sequence":"first","affiliation":[{"name":"Department of Surgery, Dentistry, Pediatrics and Gynecology, Division of Cardiac Surgery, AOUI of Verona, University of Verona , Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Diletta","family":"Trojan","sequence":"additional","affiliation":[{"name":"Treviso Tissue Bank Foundation , Treviso, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7953-8724","authenticated-orcid":false,"given":"Jacopo","family":"Gardellini","sequence":"additional","affiliation":[{"name":"Department of Surgery, Dentistry, Pediatrics and Gynecology, Division of Cardiac Surgery, AOUI of Verona, University of Verona , Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Renato","family":"di Gaetano","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Azienda Sanitaria dell\u2019Alto Adige , Bolzano, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5371-5761","authenticated-orcid":false,"given":"Giuseppe","family":"Faggian","sequence":"additional","affiliation":[{"name":"Department of Surgery, Dentistry, Pediatrics and Gynecology, Division of Cardiac Surgery, AOUI of Verona, University of Verona , Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0931-018X","authenticated-orcid":false,"given":"Giovanni Battista","family":"Luciani","sequence":"additional","affiliation":[{"name":"Department of Surgery, Dentistry, Pediatrics and Gynecology, Division of Cardiac Surgery, AOUI of Verona, University of Verona , Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2022,4,7]]},"reference":[{"key":"2022082912585261300_ezac193-B1","doi-asserted-by":"crossref","first-page":"1425","DOI":"10.1056\/NEJMcp1206782","article-title":"Infective endocarditis","volume":"368","author":"Hoen","year":"2013","journal-title":"N Engl J Med"},{"key":"2022082912585261300_ezac193-B2","doi-asserted-by":"crossref","first-page":"17539447211002687","DOI":"10.1177\/17539447211002687","article-title":"Epidemiology of infective endocarditis before versus after change of international guidelines: a systematic review","volume":"15","author":"Williams","year":"2021","journal-title":"Ther Adv Cardiovasc Dis"},{"key":"2022082912585261300_ezac193-B3","doi-asserted-by":"crossref","first-page":"2012","DOI":"10.1016\/j.athoracsur.2011.01.106","article-title":"Surgical management of endocarditis: the society of thoracic surgeons clinical practice guideline","volume":"91","author":"Byrne","year":"2011","journal-title":"Ann Thorac Surg"},{"key":"2022082912585261300_ezac193-B4","doi-asserted-by":"crossref","first-page":"633","DOI":"10.1086\/313753","article-title":"Proposed modifications to the duke criteria for the diagnosis of infective endocarditis","volume":"30","author":"Li","year":"2000","journal-title":"Clin Infect Dis"},{"key":"2022082912585261300_ezac193-B5","doi-asserted-by":"crossref","first-page":"2717","DOI":"10.1016\/j.jacc.2021.02.038","article-title":"Valve academic research consortium 3: updated endpoint definitions for aortic valve clinical research","volume":"77","author":"G\u00e9n\u00e9reux","year":"2021","journal-title":"J Am Coll Cardiol"},{"key":"2022082912585261300_ezac193-B6","doi-asserted-by":"crossref","first-page":"1309","DOI":"10.1016\/S0140-6736(02)08272-7","article-title":"Quantification of the completeness of follow-up","volume":"359","author":"Clark","year":"2002","journal-title":"Lancet"},{"key":"2022082912585261300_ezac193-B7","doi-asserted-by":"crossref","first-page":"775","DOI":"10.1016\/j.athoracsur.2010.05.034","article-title":"Hancock II bioprosthesis for aortic valve replacement: the gold standard of bioprosthetic valves durability?","volume":"90","author":"David","year":"2010","journal-title":"Ann Thorac Surg"},{"key":"2022082912585261300_ezac193-B8","doi-asserted-by":"crossref","first-page":"853","DOI":"10.1016\/j.athoracsur.2015.03.105","article-title":"Very long-term outcomes of the Carpentier-Edwards Perimount aortic valve in patients aged 60 or younger","volume":"100","author":"Bourguignon","year":"2015","journal-title":"Ann Thorac Surg"},{"key":"2022082912585261300_ezac193-B9","doi-asserted-by":"crossref","first-page":"650","DOI":"10.1016\/S0003-4975(02)03779-7","article-title":"Aortic root replacement with cryopreserved allograft for prosthetic valve endocarditis","volume":"74","author":"Sabik","year":"2002","journal-title":"Ann Thorac Surg"},{"key":"2022082912585261300_ezac193-B10","doi-asserted-by":"crossref","first-page":"1158","DOI":"10.1093\/ejcts\/ezw175","article-title":"Over 20 years experience with aortic homograft in aortic valve replacement during acute infective endocarditis","volume":"50","author":"Solari","year":"2016","journal-title":"Eur J Cardiothorac Surg"},{"key":"2022082912585261300_ezac193-B11","doi-asserted-by":"crossref","first-page":"480","DOI":"10.1016\/j.athoracsur.2011.09.074","article-title":"A graft selection for aortic root replacement in complex active endocarditis: does it matter?","volume":"93","author":"Jassar","year":"2012","journal-title":"Ann Thorac Surg"},{"key":"2022082912585261300_ezac193-B12","doi-asserted-by":"crossref","first-page":"665","DOI":"10.1016\/j.jtcvs.2009.07.026","article-title":"Homograft aortic root replacement in native or prosthetic active infective endocarditis: twenty-year single-center experience","volume":"139","author":"Musci","year":"2010","journal-title":"J Thorac Cardiovasc Surg"},{"key":"2022082912585261300_ezac193-B13","doi-asserted-by":"crossref","first-page":"1862","DOI":"10.1016\/j.athoracsur.2010.06.100","article-title":"Survival and quality of life after aortic root replacement with homografts in acute endocarditis","volume":"90","author":"Perrotta","year":"2010","journal-title":"Ann Thorac Surg"},{"key":"2022082912585261300_ezac193-B14","doi-asserted-by":"crossref","first-page":"1929","DOI":"10.1016\/j.athoracsur.2020.12.030","article-title":"Long-term outcomes of aortic valve replacement with aortic homograft: 27 years experience","volume":"112","author":"Yazdchi","year":"2021","journal-title":"Ann Thorac Surg"},{"key":"2022082912585261300_ezac193-B15","doi-asserted-by":"crossref","first-page":"231","DOI":"10.1097\/MD.0b013e318225dcb0","article-title":"Multiple-valve infective endocarditis: clinical, microbiologic, echocardiographic, and prognostic profile","volume":"90","author":"L\u00f3pez","year":"2011","journal-title":"Medicine"},{"key":"2022082912585261300_ezac193-B16","doi-asserted-by":"crossref","first-page":"256","DOI":"10.5090\/kjtcs.2013.46.4.256","article-title":"Single and multiple valve surgery in native valve infective endocarditis","volume":"46","author":"Kim","year":"2013","journal-title":"Korean J Thorac Cardiovasc Surg"},{"key":"2022082912585261300_ezac193-B17","first-page":"203","article-title":"Valve selection in aortic valve endocarditis","volume":"13","author":"Perrotta","year":"2016","journal-title":"Kardiochir Torakochirurgia Pol"},{"key":"2022082912585261300_ezac193-B18","doi-asserted-by":"crossref","first-page":"767","DOI":"10.1016\/j.athoracsur.2004.08.013","article-title":"Cryopreserved aortic viable homograft for active aortic endocarditis","volume":"79","author":"Grinda","year":"2005","journal-title":"Ann Thorac Surg"},{"key":"2022082912585261300_ezac193-B19","doi-asserted-by":"crossref","first-page":"69","DOI":"10.1016\/j.ejcts.2005.03.017","article-title":"Homograft reconstruction of the aortic root for endocarditis with periannular abscess: a 17-year study","volume":"28","author":"Yankah","year":"2005","journal-title":"Eur J Cardiothorac Surg"},{"key":"2022082912585261300_ezac193-B20","doi-asserted-by":"crossref","first-page":"1426","DOI":"10.1016\/j.athoracsur.2015.07.082","article-title":"Surgical treatment of aortic prosthetic valve endocarditis: a 20-year single-center experience","volume":"101","author":"Perrotta","year":"2016","journal-title":"Ann Thorac Surg"},{"key":"2022082912585261300_ezac193-B21","doi-asserted-by":"crossref","first-page":"1239","DOI":"10.1016\/j.jtcvs.2015.12.061","article-title":"Are homografts superior to conventional prosthetic valves in the setting of infective endocarditis involving the aortic valve?","volume":"151","author":"Kim","year":"2016","journal-title":"J Thorac Cardiovasc Surg"},{"key":"2022082912585261300_ezac193-B22","doi-asserted-by":"crossref","first-page":"142","DOI":"10.1016\/j.athoracsur.2020.04.097","article-title":"Long-term outcome and quality of life after biological aortic valve replacement in nonelderly adults","volume":"111","author":"Petersen","year":"2021","journal-title":"Ann Thorac Surg"},{"key":"2022082912585261300_ezac193-B23","doi-asserted-by":"crossref","first-page":"35","DOI":"10.1016\/j.ejcts.2010.11.025","article-title":"Re-operations for aortic allograft root failure: experience from a 21-year single-center prospective follow-up study","volume":"40","author":"Bekkers","year":"2011","journal-title":"Eur J Cardiothorac Surg"},{"key":"2022082912585261300_ezac193-B24","doi-asserted-by":"crossref","first-page":"761","DOI":"10.1016\/j.athoracsur.2008.01.102","article-title":"Aortic allograft valve reoperation: surgical challenges and patient risks","volume":"86","author":"Nowicki","year":"2008","journal-title":"Ann Thorac Surg"},{"key":"2022082912585261300_ezac193-B25","doi-asserted-by":"crossref","first-page":"404","DOI":"10.1016\/j.ejcts.2011.04.043","article-title":"Outcome after homograft redo operation in aortic position","volume":"41","author":"Kowert","year":"2012","journal-title":"Eur J Cardiothorac Surg"},{"key":"2022082912585261300_ezac193-B26","doi-asserted-by":"crossref","first-page":"764","DOI":"10.1016\/j.jtcvs.2015.10.113","article-title":"Long-term survival, valve durability, and reoperation for 4 aortic root procedures combined with ascending aorta replacement","volume":"151","author":"Svensson","year":"2016","journal-title":"J Thorac Cardiovasc Surg"},{"key":"2022082912585261300_ezac193-B27","doi-asserted-by":"crossref","first-page":"494","DOI":"10.1053\/j.semtcvs.2017.09.010","article-title":"Long-term evaluation of the ross procedure in acute infective endocarditis","volume":"29","author":"Ratschiller","year":"2017","journal-title":"Semin Thorac Cardiovasc Surg"},{"key":"2022082912585261300_ezac193-B28","doi-asserted-by":"crossref","first-page":"62","DOI":"10.1016\/j.ijcard.2015.10.071","article-title":"Ross procedure is a safe treatment option for aortic valve endocarditis: long-term follow-up of 42 patients","volume":"203","author":"Ringle","year":"2016","journal-title":"Int J Cardiol"}],"container-title":["European Journal of Cardio-Thoracic Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/ejcts\/article-pdf\/62\/3\/ezac193\/45612047\/ezac193.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ejcts\/article-pdf\/62\/3\/ezac193\/45612047\/ezac193.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,8,29]],"date-time":"2022-08-29T09:00:18Z","timestamp":1661763618000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/ejcts\/article\/doi\/10.1093\/ejcts\/ezac193\/6564539"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,4,7]]},"references-count":28,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2022,8,3]]}},"URL":"https:\/\/doi.org\/10.1093\/ejcts\/ezac193","relation":{},"ISSN":["1010-7940","1873-734X"],"issn-type":[{"value":"1010-7940","type":"print"},{"value":"1873-734X","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2022,9,1]]},"published":{"date-parts":[[2022,4,7]]},"article-number":"ezac193"}}