Mid-Term Results of Valve-Sparing Aortic Root Replacement in Patients With Expanded Indications

Miyahara, Shunsuke; Matsueda, Takashi; Izawa, Naoto; Yamanaka, Katsuhiro; Sakamoto, Toshihito; Nomura, Yoshikatsu; Morimoto, Naoto; Inoue, Takeshi; Matsumori, Masamichi; Okada, Kenji; Okita, Yutaka

doi:10.1016/j.athoracsur.2014.09.091

Cited by 31 publications

(24 citation statements)

References 22 publications

(23 reference statements)

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“…In fact, more aggressive correction of cusp prolapse after the introduction of the effective height concept (10) in this subset of patients was associated with significantly better long-term results. Similar observations were made by others (21) who found reduced valve durability in patients with particularly large root size (21). Thus our experience and that of others seems to indicate that cusp prolapse rather than annular dilatation may be the main reason for recurrence of AR.…”

Section: Discussionsupporting

confidence: 75%

Valve-sparing aortic root replacement in patients with Marfan syndrome—the Homburg experience

Schneider¹,

Ehrlich²,

Karliova³

et al. 2017

Ann. Cardiothorac. Surg.

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Section: Discussionsupporting

confidence: 75%

Valve-sparing aortic root replacement in patients with Marfan syndrome—the Homburg experience

Schneider¹,

Ehrlich²,

Karliova³

et al. 2017

Ann. Cardiothorac. Surg.

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“…Survival rate at one year was reported to be 97.6±2.6% by David et al [9] and 97±1.5% by Forteza et al [10] Overall survival was 96.2±0.03% and 96.2±0.03% at five, and seven years during follow-up. Five-year and 15-year survival rates were reported to be 95.1±3.5%, and 76.5±18% by David et al [9] Miyahara et al [11] reported that overall survival was 96.6±1.6% and 90.1±6.4% at five and 10 years in patients with expanded indications (24.6% connective tissue disorders; 19.1% BAV; 11.5% acute type A aortic dissection).…”

Section: Discussionmentioning

confidence: 99%

“…Our mid-term outcomes with valve-sparing aortic root replacement are similar to those reported in the literature. [4,9,11] Most series report in-hospital mortality between 0% and 6% among patients who underwent reimplantation procedures. [8] The largest series in the literature with long-term follow-up was reported by David et al [9] in 2013 and included data of 296 patients (36% MFS and 11% BAV).…”

Section: Discussionmentioning

confidence: 99%

“…[7,8] In patients with a dilated aortic root, aortic valve preservation is technically challenging and controversy persists regarding the durability of the aortic root repair using the reimplantation technique and reproducibility of the procedure, although several authors have reported excellent durability of valvesparing surgeries. [9][10][11][12][13] Therefore, in this study, we aimed to report early and mid-term results of valvesparing aortic root replacement using the David's reimplantation technique in a single-center.…”

mentioning

confidence: 99%

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Mid-term results of aortic root repair using the reimplantation technique: our single-center experience

Demi̇rdaş¹

2016

Turk Gogus Kalp Dama

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Bu çalışmada reimplantasyon tekniği kullanılarak kapak koruyucu aort kök replasmanının erken ve orta dönem sonuçları bildirildi. Ça lış ma pla nı: Ocak 2008-Haziran 2015 tarihleri arasında, tek merkezde tek cerrah tarafından David-V tekniği kullanılarak kapak koruyucu aort kök replasmanı yapılan toplam ardışık 54 hasta (44 erkek, 10 kadın; ort. yaş 58±12.3 yıl; dağılım 26-80 yıl) retrospektif olarak incelendi. Bul gu lar: Hastane içi mortalite oranı %1.9 idi. Medyan takip süresi 57.5 (dağılım 29.5-77) ay idi. Cerrahinin ilk yılında iki hastada şiddetli aort yetmezliği gelişti ve aort kapak replasmanı yapıldı. Bir, beş ve yedinci yılda tahmini sağkalım oranı sırasıyla %96.2±0.03, %96.2±0.03 ve %96.2±0.03 idi. Orta ila şiddetli aort yetmezliği olmaksızın sağkalım oranı bir, beş ve yedinci yılda sırasıyla %96.2±0.03, %96.2±0.03 ve %96.2±0.03 idi. Bir, beş ve yedinci yılda yeniden kapak ameliyatı olmaksızın sağkalım oranı sırasıyla %96.2±0.03, %96.2±0.03 ve %96.2±0.03 idi. So nuç: Kapak koruyucu aort kök reimplantasyon işlemlerimizin erken ve orta dönem sonuçları mükemmeldir. Anah tarsöz cük ler: Aort yetmezliği; aort kök anevrizması; aort kök replasmanı; David reimplantasyon tekniği; kapak koruyucu.

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“…Similar results have been reported from Hannover, Germany (50). Okita's group in Kobe, Japan had equivalent perioperative results (5% mortality rate amongst 21 patients), but AcA-AoD was a significant risk factor for both recurrent aortic regurgitation and reoperation in their overall experience with V-SARR (99).…”

Section: Replacement Of the Valve And Rootmentioning

confidence: 99%

Evolution of surgical therapy for Stanford acute type A aortic dissection

Chiu¹,

Miller²

2016

ASVIDE

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Acute type A aortic dissection (AcA-AoD) is a surgical emergency associated with very high morbidity and mortality. Unfortunately, the early outcome of emergency surgical repair has not improved substantially over the last 20 years. Many of the same debates occur repeatedly regarding operative extent and optimal conduct of the operation. The question remains: are patients suffering from too large an operation or too small?The pendulum favoring routine aortic valve resuspension, when feasible, has swung towards frequent aortic root replacement. This already aggressive approach is now being challenged with the even more extensive valve-sparing aortic root replacement (V-SARR) in selected patients. Distally, open replacement of most of the transverse arch is best in most patients. The need for late aortic re-intervention has not been shown to be affected by more extensive distal operative procedures, but the contemporary enthusiasm for a distal frozen elephant trunk (FET) only seems to build. It must be remembered that the first and foremost goal of the operation is to have an operative survivor; additional measures to reduce late morbidity are secondary aspirations. With increasing experience, true contraindications to emergency surgical operation have dwindled, but patients with advanced age, multiple comorbidities, and major neurological deficits do not fare well. The endovascular revolution, moreover, has spawned innovative options for modern practice, including ascending stent graft and adaptations of the old flap fenestration technique. Despite the increasingly complex operations and ever expanding therapies, this life-threatening disease remains a stubborn challenge for all cardiovascular surgeons. Development of specialized thoracic aortic teams and regionalization of care for patients with AcA-AoD offers the most promise to improve overall results.

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Mid-Term Results of Valve-Sparing Aortic Root Replacement in Patients With Expanded Indications

Cited by 31 publications

References 22 publications

Valve-sparing aortic root replacement in patients with Marfan syndrome—the Homburg experience

Valve-sparing aortic root replacement in patients with Marfan syndrome—the Homburg experience

Mid-term results of aortic root repair using the reimplantation technique: our single-center experience

Evolution of surgical therapy for Stanford acute type A aortic dissection

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