Replacement of the aortic valve and ascending aorta with an extended root stentless xenograft

Purpose. We present an early series to determine the technical feasibility of simultaneous aortic valve and complete ascending aortic replacement using a longer stentless aortic xenograft, harvested with an extended root. Description. The stentless xenograft valved conduits commercially available are too short for complete ascending aorta replacement, and usually a prosthetic tube graft is required distally. Evaluation. To avoid this extra prosthetic conduit distally a number of stentless aortic xenografts with extended conduit were obtained from a supplier (Medtronic Inc). They were inserted in 6 elderly patients (67.8 +/- 7.1 years) who all required aortic valve and ascending aorta replacements owing to pathologic dilation. Conclusions. In all cases an extra prosthetic conduit was avoided, and the length of the available biological conduit comfortably allowed total ascending aortic replacement without tension. The advantages therefore were one less suture line, cost saving regarding the prosthetic conduit, shorter cross-clamping time, and possibly shorter time spent on hemostasis. (C) 2004 by The Society of Thoracic Surgeons.