Aortic Root Replacement with Cryopreserved Allograft for Endocarditis

Aortic valve allograft is the most forgiving pliable conduit to be implanted in an infected and inflamed left ventricular outflow tract and aortic root. The allograft provides the versatility of repairing the aorto-mitral curtain and anterior mitral valve leaflet in situations with root destruction extending toward the mitral valve. Early mortality is acceptable, risk of reinfection is low, durability is similar to that of bioprostheses, and reoperation after for allograft degeneration and failure can be done safely. The allograft remains our preferred conduit for root reconstruction and replacement in patients with advanced invasive infective endocarditis of the aortic root and valve but successful use of allografts requires training, continuous exposure, and reasonable volume.