{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,1]],"date-time":"2025-11-01T06:20:18Z","timestamp":1761978018989,"version":"build-2065373602"},"reference-count":38,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"11_suppl_1","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circulation"],"published-print":{"date-parts":[[2013,9,10]]},"abstract":"<jats:sec>\n            <jats:title>Background\u2014<\/jats:title>\n            <jats:p>The choice of the best conduit for root\/ascending disease and its impact on longevity remain controversial in quinquagenarians.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods and Results\u2014<\/jats:title>\n            <jats:p>\n              A total of 205 patients (men=155) between 50 and 60 years (mean, 55.7\u00b12.9 years) received either a stentless porcine xenoroot (n=78) or a mechanically valved composite prosthesis (n=127) between February 1998 and July 2011. Of these, 166 patients underwent root replacement for aneurysmal disease (porcine: 39% [n=65]; mechanical: 61% [n=101];\n              <jats:italic>P<\/jats:italic>\n              =0.5), 25 for acute type A aortic dissection (porcine: 32% [n=8]; mechanical: 68% [n=17];\n              <jats:italic>P<\/jats:italic>\n              =0.51), and 14 for endocarditis\/iatrogenic injury involving the aortic root (6.4% [n=5] versus 7.1% [n=9];\n              <jats:italic>P<\/jats:italic>\n              =1.0). The predominant aortic valve pathology was stenosis in 19% (n=38), regurgitation in 50% (n=102), combined valvular dysfunction in 26% (n=54), and normal aortic valve function in 5% (n=11). Concomitant procedures included coronary artery bypass grafting (13%), mitral valve repair (7%), and partial\/complete arch replacement (12%\/4%), with no significant differences between porcine and mechanical root replacement. Overall hospital mortality was 7.3%, with no difference between the 2 types of valve prostheses (7.7% for porcine and 7.1% for mechanical root replacement;\n              <jats:italic>P<\/jats:italic>\n              =1.0). Follow-up averaged 5.4\u00b13.7 years (1096 patient-years) and was 100% complete. Freedom from aorta-related reoperation at 12 years was not statistically different between the groups (porcine: 94.9% versus mechanical: 96.1%;\n              <jats:italic>P<\/jats:italic>\n              =0.73). Survival was equivalent between both groups, with a 5-year survival of 86\u00b13% (porcine: 88\u00b14%; mechanical: 85\u00b13%;\n              <jats:italic>P<\/jats:italic>\n              =0.96) and a 10-year survival of 76% (porcine: 80\u00b17%; mechanical: 75\u00b15%;\n              <jats:italic>P<\/jats:italic>\n              =0.84). The linearized mortality rate was 3.1%\/patient-year (porcine: 2.9%\/patient-year; mechanical: 3.2%\/patient-year).\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions\u2014<\/jats:title>\n            <jats:p>In quinquagenerians, long-term survival after stentless porcine xenograft aortic root replacement is equivalent to that after a mechanical Bentall procedure. These results bring into question the predominance of mechanical composite conduits for root replacement in quinquagenerians, particularly in the current era of transcatheter valve-in-valve procedures for structural valve deterioration.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/circulationaha.112.000338","type":"journal-article","created":{"date-parts":[[2013,9,12]],"date-time":"2013-09-12T21:37:10Z","timestamp":1379021830000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":18,"title":["Longevity After Aortic Root Replacement"],"prefix":"10.1161","volume":"128","author":[{"given":"Christian D.","family":"Etz","sequence":"first","affiliation":[{"name":"From the Department of Cardiac Surgery, Heart Center Leipzig, University of Leipzig, Leipzig, Germany."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Felix F.","family":"Girrbach","sequence":"additional","affiliation":[{"name":"From the Department of Cardiac Surgery, Heart Center Leipzig, University of Leipzig, Leipzig, Germany."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Konstantin","family":"von Aspern","sequence":"additional","affiliation":[{"name":"From the Department of Cardiac Surgery, Heart Center Leipzig, University of Leipzig, Leipzig, Germany."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Roberto","family":"Battellini","sequence":"additional","affiliation":[{"name":"From the Department of Cardiac Surgery, Heart Center Leipzig, University of Leipzig, Leipzig, Germany."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pascal","family":"Dohmen","sequence":"additional","affiliation":[{"name":"From the Department of Cardiac Surgery, Heart Center Leipzig, University of Leipzig, Leipzig, Germany."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alexandro","family":"Hoyer","sequence":"additional","affiliation":[{"name":"From the Department of Cardiac Surgery, Heart Center Leipzig, University of Leipzig, Leipzig, Germany."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maximilian","family":"Luehr","sequence":"additional","affiliation":[{"name":"From the Department of Cardiac Surgery, Heart Center Leipzig, University of Leipzig, Leipzig, Germany."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Martin","family":"Misfeld","sequence":"additional","affiliation":[{"name":"From the Department of Cardiac Surgery, Heart Center Leipzig, University of Leipzig, Leipzig, Germany."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael A.","family":"Borger","sequence":"additional","affiliation":[{"name":"From the Department of Cardiac Surgery, Heart Center Leipzig, University of Leipzig, Leipzig, Germany."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Friedrich W.","family":"Mohr","sequence":"additional","affiliation":[{"name":"From the Department of Cardiac Surgery, Heart Center Leipzig, University of Leipzig, Leipzig, Germany."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0003-4975(03)00568-X"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtcvs.2010.07.033"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1136\/thx.23.4.338"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0003-4975(10)63723-X"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(62)90345-8"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1136\/thx.19.2.131"},{"key":"e_1_3_3_8_2","first-page":"5733","article-title":"[Implantation of heterogenic valves in the treatment of aortic cardiopathies].","volume":"261","author":"Binet JP","year":"1965","unstructured":"Binet JP, Carpentier A, Langlois J, Duran C, Colvez P. [Implantation of heterogenic valves in the treatment of aortic cardiopathies]. C R Acad Sci Hebd Seances Acad Sci D. 1965;261:5733\u20135734.","journal-title":"C R Acad Sci Hebd Seances Acad Sci D"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/0003-4975(95)00066-T"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1540-8191.1988.tb00444.x"},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0003-4975(02)04144-9"},{"key":"e_1_3_3_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtcvs.2007.01.058"},{"key":"e_1_3_3_13_2","doi-asserted-by":"publisher","DOI":"10.1093\/ejcts\/ezs011"},{"key":"e_1_3_3_14_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.108.190748"},{"key":"e_1_3_3_15_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehs109"},{"key":"e_1_3_3_16_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.106.681429"},{"key":"e_1_3_3_17_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejcts.2006.06.013"},{"key":"e_1_3_3_18_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtcvs.2007.10.065"},{"key":"e_1_3_3_19_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2012.01.106"},{"key":"e_1_3_3_20_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtcvs.2007.12.002"},{"key":"e_1_3_3_21_2","doi-asserted-by":"publisher","DOI":"10.1136\/heart.89.7.715"},{"key":"e_1_3_3_22_2","doi-asserted-by":"publisher","DOI":"10.1053\/j.semtcvs.2012.04.001"},{"key":"e_1_3_3_23_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2009.03.058"},{"key":"e_1_3_3_24_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-5223(98)70014-5"},{"key":"e_1_3_3_25_2","first-page":"649","article-title":"Freedom from structural valve deterioration among patients aged <60 years undergoing Freestyle stentless aortic valve replacement.","volume":"16","author":"Bach DS","year":"2007","unstructured":"Bach DS, Metras J, Doty JR, Yun KL, Dumesnil JG, Kon ND. Freedom from structural valve deterioration among patients aged <60 years undergoing Freestyle stentless aortic valve replacement. J Heart Valve Disease. 2007;16:649\u2013656.","journal-title":"J Heart Valve Disease"},{"key":"e_1_3_3_26_2","first-page":"393","article-title":"Predicting ATS Open Pivot heart valve performance with computational fluid dynamics.","volume":"14","author":"Dumont K","year":"2005","unstructured":"Dumont K, Vierendeels JA, Segers P, Van Nooten GJ, Verdonck PR. Predicting ATS Open Pivot heart valve performance with computational fluid dynamics. J Heart Valve Dis. 2005;14:393\u2013399.","journal-title":"J Heart Valve Dis"},{"key":"e_1_3_3_27_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0003-4975(02)04537-X"},{"key":"e_1_3_3_28_2","first-page":"88","article-title":"Twenty years\u2019 single-center experience with mechanical heart valves: a critical review of anticoagulation policy.","volume":"21","author":"Van Nooten GJ","year":"2012","unstructured":"Van Nooten GJ, Caes F, Fran\u00e7ois K, Van Bellleghem Y, Bov\u00e9 T, Vandenplas G, Taeymans Y. Twenty years\u2019 single-center experience with mechanical heart valves: a critical review of anticoagulation policy. J Heart Valve Dis. 2012;21:88\u201398.","journal-title":"J Heart Valve Dis"},{"key":"e_1_3_3_29_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtcvs.2011.12.059"},{"key":"e_1_3_3_30_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11748-012-0124-1"},{"key":"e_1_3_3_31_2","first-page":"151","article-title":"Single-center outcome analysis of 1,161 patients with St. Jude medical and ATS open pivot mechanical heart valves.","volume":"16","author":"Bernet FH","year":"2007","unstructured":"Bernet FH, Baykut D, Grize L, Zerkowski HR. Single-center outcome analysis of 1,161 patients with St. Jude medical and ATS open pivot mechanical heart valves. J Heart Valve Dis. 2007;16:151\u2013158.","journal-title":"J Heart Valve Dis"},{"key":"e_1_3_3_32_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0003-4975(03)00016-X"},{"key":"e_1_3_3_33_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtcvs.2012.07.041"},{"key":"e_1_3_3_34_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2007.04.061"},{"key":"e_1_3_3_35_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtcvs.2011.08.041"},{"key":"e_1_3_3_36_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtcvs.2011.02.006"},{"key":"e_1_3_3_37_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtcvs.2012.01.024"},{"key":"e_1_3_3_38_2","doi-asserted-by":"publisher","DOI":"10.1161\/circinterventions.112.972331"},{"key":"e_1_3_3_39_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcin.2011.07.015"}],"container-title":["Circulation"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ahajournals.org\/doi\/full\/10.1161\/CIRCULATIONAHA.112.000338","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,13]],"date-time":"2024-05-13T06:42:12Z","timestamp":1715582532000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ahajournals.org\/doi\/10.1161\/CIRCULATIONAHA.112.000338"}},"subtitle":["Is the Mechanically Valved Conduit Really the Gold Standard for Quinquagenarians?"],"short-title":[],"issued":{"date-parts":[[2013,9,10]]},"references-count":38,"journal-issue":{"issue":"11_suppl_1","published-print":{"date-parts":[[2013,9,10]]}},"alternative-id":["10.1161\/CIRCULATIONAHA.112.000338"],"URL":"https:\/\/doi.org\/10.1161\/circulationaha.112.000338","relation":{},"ISSN":["0009-7322","1524-4539"],"issn-type":[{"type":"print","value":"0009-7322"},{"type":"electronic","value":"1524-4539"}],"subject":[],"published":{"date-parts":[[2013,9,10]]},"assertion":[{"value":"2013-09-10","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}