• Christian D Etz, Moritz S Bischoff, Carol Bodian, Fabian Roder, Robert Brenner, Randall B Griepp, and Gabriele Di Luozzo.
• Departments of Cardiothoracic Surgery and Anesthesia, Mount Sinai School of Medicine, New York, NY, USA.
• J. Thorac. Cardiovasc. Surg. 2010 Dec 1; 140 (6 Suppl): S64-70; discussion S86-91.

ObjectivesWe compared aortic root reconstructions using conduits with biological valves and mechanical valves.MethodsOf 597 patients (1995-2008), 307 (mean age 71 years [23-89 years]) had biological valves and 290 (mean age 51 years [21-82 years]) had mechanical valves. The subgroup of 242 patients aged 50 to 70 years included 133 with biological and 109 with mechanical valves.ResultsOverall hospital mortality was 3.9% with biological valves (n = 15; elective: 3.7% [n = 10]) versus 2.8% with mechanical valves (n = 8; elective: 1.4% [n = 3]). In patients 50 to 70 years, age greater than 65 years (relative risk: 3.3 [P = .0001]), clot (relative risk: 2.5 [P = .05]), coronary artery disease (relative risk:3.5 [P < .0001]), and degenerative etiology (relative risk: 0.4 [P = .006]) were independent risk factors for long-term survival (after postoperative day 30); there was no difference in long-term survival between biological and mechanical valves (relative risk: 0.9 [P = .74]). The linearized rate for valve/ascending aorta reoperation was 0.86%/pt-y (2 in 2310 pt-y) after mechanical valves and 2.5%/pt-y (4 in 1586 pt-y) after Bentall procedures with the biological valve.ConclusionsThe choice of valve for aortic root reconstruction seems to have no influence on long-term outcome. Emergency operation and the presence of clot/atheroma have a significant impact on short-term outcome. Reoperation for either ascending aorta and/or aortic valve is low.Copyright © 2010 The American Association for Thoracic Surgery. Published by Mosby, Inc. All rights reserved.

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