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Background: Since 1968 Bentall and DeBono first described the technique for aortic root replacement with the reimplantation of the coronary arteries. This operation has been considered the gold standard in the surgical treatment of the ascending aorta and aortic valve disease. At the end of the 1990 s the Shelhigh No-React biological valved conduit was introduced in Europe for Bentall operation. The aim this study was to report the short and long term follow-up with the Shelhigh conduit. Methods: From 2001 to 2010, 45 patients (mean age 69.6 ± 6.9 years) underwent aortic root replacement with Shelhigh conduit. Endocarditis (2.2%), type A aortic dissection (20%), aneurysm (77.8%) were the most important indications for surgery. End-points were: survival at 1, 5 and 10years, conduit-related major complications and death, freedom from aortic root structural deterioration and reoperation. Results: The median follow-up was 8.9 years (0 to 14.6). The overall hospital mortality rate was 4 patients (8.9 %). The overall estimated survival rates at 1, 5 and 10 years were 86.4 ± 5.2, 81.8 ± 5.8 and 65.9 ± 7.6 respectively. Redo surgery was necessary in 5 cases (11.1 %); in 3 of them (6.7%) there was evidence of false aneurysm. The overall estimated freedom from reoperation at 1, 5 and 10 years was 95.1 ± 3.4, 92.6 ± 4.1 and 92.6 ± 4.1 respectively. Conclusions: In our experience the Shelhigh-NoReact biological valved conduit showed acceptable results. According to the literature, the high rate of aortic root related reoperation (6.7%) and early mortality (8.9%) may be explained by the clinical and demographic features of the studied group.

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