naa a22 4500 510728391 CHVBK 20180411082943.0 cr unu---uuuuu 180411e20130401xx s 000 0 eng 10.1007/s11748-012-0152-x doi (NATIONALLICENCE)springer-10.1007/s11748-012-0152-x Surgical treatment for aortic periannular abscess/pseudoaneurysm caused by infective endocarditis [Elektronische Daten] [Kenji Okada, Yutaka Okita] Delayed diagnosis or surgery sometimes causes more extensive destruction of aortic periannular abscess, or pseudoaneurysm, resulting in left ventricular-aortic discontinuity, particularly in patients with prosthetic valve endocarditis. The condition complicates the surgical procedures and causes worsening of short- and long-term outcomes. In-hospital mortality in patients with prosthetic valve endocarditis has been reported to be as high as 15-20%, even at leading hospitals in the world. Contemporary modes of surgery for periannular abscess/pseudoaneurysm involve drainage of the cavity, radical debridement of necrotic tissue, annular reconstruction of the destroyed annulus, and root replacement using an optimal conduit. Radical debridement is of primary importance and is the universally accepted procedure, which frequently requires annular reconstruction using a pericardial patch. Conventional aortic valve replacement using a mechanical or stented biological valve, aortic valve replacement with translocation, aortic root replacement using an allograft, pulmonary autograft (Ross procedure), stentless biological valve, or a composite graft are conduits of choice. All things considered, allograft is believed to be the best conduit for a destroyed annulus because of better fit and its resistance to infection; however, recent reports have failed to confirm the superiority of allograft over other conduits in terms of long-term survival and freedom from reoperation/recurrence of infection. Short- and long-term outcomes have been studies for every type of conduit, but the selection of conduits for aortic root replacement is still controversial. The Japanese Association for Thoracic Surgery, 2012 Infective endocarditis nationallicence Aortic periannular abscess nationallicence Aortic periannular pseudoaneurysm nationallicence Okada Kenji Division of Cardiovascular Surgery, Department of Surgery, Kobe University Graduate School of Medicine, 7-5-2, Kusunoki-Cho, Chuo-ku, 650-0017, Kobe, Hyogo, Japan aut Okita Yutaka Division of Cardiovascular Surgery, Department of Surgery, Kobe University Graduate School of Medicine, 7-5-2, Kusunoki-Cho, Chuo-ku, 650-0017, Kobe, Hyogo, Japan aut General Thoracic and Cardiovascular Surgery Springer Japan 61/4(2013-04-01), 175-181 1863-6705 61:4<175 2013 61 11748 https://doi.org/10.1007/s11748-012-0152-x text/html Onlinezugriff via DOI 1 review-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s11748-012-0152-x text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Okada Kenji Division of Cardiovascular Surgery, Department of Surgery, Kobe University Graduate School of Medicine, 7-5-2, Kusunoki-Cho, Chuo-ku, 650-0017, Kobe, Hyogo, Japan aut NATIONALLICENCE 700 1- Okita Yutaka Division of Cardiovascular Surgery, Department of Surgery, Kobe University Graduate School of Medicine, 7-5-2, Kusunoki-Cho, Chuo-ku, 650-0017, Kobe, Hyogo, Japan aut NATIONALLICENCE 773 0- General Thoracic and Cardiovascular Surgery Springer Japan 61/4(2013-04-01), 175-181 1863-6705 61:4<175 2013 61 11748 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer