DR JUAN CRESTANELLO: Welcome to the Cardiovascular Surgery Series where we will review the latest research in cardiovascular surgery from the Mayo Clinic in just 2 minutes. I am Dr. Juan Crestanello and I am a cardiac surgeon at the Mayo Clinic in Rochester, Minnesota. We will discuss today comparative effectiveness of mechanical valves and homograft in complex aortic endocarditis.

The ideal route reconstruction for patients with aortic root endocarditis is still controversial. We compare route reconstructions with homografts, bioprostheses, and mechanical valves for complex root endocarditis over a 15 year period. The use of homograft decreased during the study period. Risk-adjusted operative mortality was higher with homograft and lower for mechanical valves.

Long-term survival after root replacement was worse with homograft than with mechanical valve conduits. The findings of this study highlights that the most important concept for treatment of root endocarditis is to remove all infected tissue by complete debridement. After complete debridement, surgeons can choose the material they are most comfortable with to reconstruct the aortic root. Thank you for listening to the Mayo Clinic Cardiovascular Surgery Series.