Preservation of the aortic valve in acute aortic dissection: Long-term echocardiographic assessment and clinical outcome

Mazzucotelli, J. P.; Deleuze, Philippe; Baufreton, Christophe; Duval, Anne Marie; Hillion, Marie Line; Loisance, D; Cachera, J P

doi:10.1016/0003-4975(93)91100-2

Cited by 91 publications

(65 citation statements)

References 16 publications

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“…Multiple root repair techniques using prosthetic and biologic materials have been reported (4)(5)(6)(7)(8)(9). The two most commonly described methods involve fortification of the aortic wall using Teflon felt and/or biologic glue.…”

Section: Aortic Root Repairmentioning

confidence: 99%

When and how to replace the aortic root in type A aortic dissection

Leshnower

Chen

2016

Ann. Cardiothorac. Surg.

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Management of aortic root pathology during repair of acute type A aortic dissection (TAAD) requires a comprehensive evaluation of the patient's anatomy, demographics, comorbidities and physiologic status at the time of emergent operative intervention. Surgical options include conservative repair of the root (CRR) (with or without replacement of the aortic valve), replacement of the native valve and aortic root using a composite valve-conduit and valve sparing root replacement (VSRR). The primary objective of this review is to provide data for surgeons to aid in their decision-making process regarding management of the aortic root during repair of TAAD. No time or language restrictions were imposed and references of the selected studies were checked for additional relevant citations. Multiple retrospective reviews have demonstrated equivalent operative mortality between aortic root repair and replacement during TAAD. There is a higher incidence of aortic root reintervention with aortic root repair compared to aortic root replacement (ARR). Experienced, high-volume aortic centers have demonstrated the safety of VSRR in young, hemodynamically stable patients presenting with TAAD. In conclusion, aortic root repair can safely be performed in the vast majority of patients with TAAD. Despite the increased surgical complexity, ARR does not increase operative mortality and improves the freedom from root reintervention. VSRR can be performed in highly selected populations of patients with TAAD with durable mid-term valve function.

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Section: Aortic Root Repairmentioning

confidence: 99%

When and how to replace the aortic root in type A aortic dissection

Leshnower

Chen

2016

Ann. Cardiothorac. Surg.

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“…Unfortunately, all of the surgeons who deal with type A aortic dissection in the middle of the night are not always used to this approach. Supracommissural tube graft replacement in conjunction with reconstruction of the sinuses with glue is the easiest way to treat type A aortic dissection [Fann et al, 1991, Kouchoukos et al, 1991, Mazzucotelli et al, 1993. This technique allows in almost 90% of the patients the restoring of the geometry of the aortic sinuses and subsequently the valve competence which is failing in many cases.…”

Section: Discussionmentioning

confidence: 99%

“…These are: intra-pericardial rupture and tamponade, malperfusion phenomena (coronary, neurological, visceral) and acute aortic valve regurgitation. Despite excellent results from individual surgeons and expert centres, operative outcomes for TAAD have remained static with mortality rates from large databases that perhaps better reflect "real-world" practice still around 15 to 30% [Ergin et al, 1996, Fann et al, 1991, Kouchoukos et al, 1991, Mazzucotelli et al, 1993, Nienaber et al, 2003a, 2003b, von Segesser et al, 1996. Since the past decade, the reimplantation aortic valve sparing technique (David I) has been proposed as an alternative to supra commissural replacements or to modified BentalldeBono procedures for repair of TAAD, based upon the principle of totally resecting the aortic root, but leaving in place a macroscopically intact aortic valve .…”

Section: Introductionmentioning

confidence: 99%

Reimplantation Valve Sparing Procedure in Type A Aortic Dissection: A Predictive Factor of Mortality and Morbidity?

Farhat¹,

Bejan-Angoulvant²,

Abdallah³

et al. 2011

Diagnosis and Treatment of Abdominal and Thoracic Aortic Aneurysms Including the Ascending Aorta and the Aortic Arch

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“…[25][26][27][28] This technique has been proven by several authors inasmuch as the freedom from reoperation for aortic valve dysfunction was 91% to 82% after 10 years. 8,28 The major drawback of this technique is the need of reoperation due to sinus of Valsalva aneurysm. Our results are not similar to that study since our patients did not need a reoperation.…”

Section: Discussionmentioning

confidence: 99%

“…However, preservation of the native aortic root may have the potential of long-term changes of both aortic valve and root such as secondary aortic regurgitation with or without progressive root dilatation. 5,8 This late complication is particularly apparent in patients with the Marfan syndrome and annuloaortic ectasis. 9 For these patients, some groups favor a more aggressive approach, such as Bentall type operations to the aortic valve and root pathology to eliminate the need for reoperation.…”

mentioning

confidence: 99%

Supracommissural Aortic Replacement: A Reliable Option for Acute and Chronic Aortic Type A Dissection

Güler¹,

Toker²,

Eren³

et al. 2010

Turkiye Klinikleri J Med Sci

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A AB BS S T TR RA AC CT T O Ob b j je ec c t ti i v ve e: : To re vi ew early and la te re sults of sup ra com mis su ral aor tic rep la ce ment in pa ti ents with acu te and chro nic type A dis sec ti on. M Ma a t te e r ri i a al l a an nd d M Me et t h ho od ds s: : From Feb ru ary 1985 to Oc to ber 2005, 162 pa ti ents with acu te and chro nic aor tic dis sec ti on un der went sup ra com mis su ral aor tic graft rep la ce ment. A ret ros pec ti ve cli ni cal re vi ew was un der ta ken using hos pi tal re cords, clini cal and ec ho car di og rap hic da ta, and te lep ho ne in ter vi ews with pa ti ents. R Re e s su ul lt ts s: : The re we re 23 (14.1 %) ope ra ti ve and eight (6.4 %) la te de aths. The most com mon ca u ses of hos pi tal de ath we re in tra o pe ra ti ve comp li ca ti ons re la ted to he morr ha ge (n= 9), and res pi ra tory fa i lu re (n = 6), and the ot her ca u se was mul ti or gan fa i lu re (n= 5). The hos pi tal mor ta lity ra te for pa ti ents with chro nic type A dis sec ti on was 6.25% (3/48). The ca u ses of de ath we re res pi ra tory fa i lu re (n= 2) and mul ti or gan fa i lu re (n= 1). The mo des of hos pi tal de aths we re not re la ted to re si du al aor tic in suf fi ci ency (AR) in any ca se sin ce early pos to pe ra ti ve trans tho ra cic ec ho car di og raphy did not show gra ter than grade II in the se pa ti ents in early pos to pe ra ti ve or fol low-up pe ri od, trans tho ra cic ec ho car di og raphy did not show aor tic re gur gi ta ti on gra ter than gra de II in any ca se. All sur vi vors we re in New York He art As so ci a ti on class I or II at the last vi sit. C Co on nc c l lu u s si i o on n: : Sup ra com mis su ral aor tic graft rep la cement pro vi des sa tis fac tory re sults for many pa ti ents with as cen ding aor tic dis sec ti on. The func ti on of the pre ser ved aor tic val ves re ma i ned unc han ged in the ma jo rity of the pa ti ents du ring the first fi ve ye ars of fol low-up. K Ke ey y W Wo or rd ds s: : Aor ta; aor tic val ve in suf fi ci ency; aor tic val ve Ö ÖZ ZE ET T A Am ma aç ç: : Sup ra ko mis su ral aort rep las ma nı uy gu la nan akut ve kro nik Tip A aort dis sek si yon lu ol gu la rın er ken ve geç dö nem so nuç la rı nın göz den ge çi ril me si. G Ge e r re eç ç v ve e Y Yö ön n t te em m l le er r: : Şubat 1985 ile Ekim 2005 ta rih le ri ara sın da akut ve kro nik dis sek si yo nu olan 162 ol gu ya sup ra kom mis su ral aort gretf rep las ma nı uy gu lan dı. Kli nik bul gu lar ret ros pek tif ola rak has ta ka yıt la rı, kli nik ve eko kar diyog ra fik bul gu lar ve has ta lar la te le fon gö rüş me le ri ile sağ lan dı. B Bu ul l g gu u l la ar r: : Yir mi üç (%14.1) ope ratif, se kiz (%5.8) geç dö nem mor ta li te si mev cut tu. En sık ölüm ne den le ri, in tra o pe ra tif komp li kasyon la ra bağ lı ola rak, ka na ma (n=9), so lu num yet mez li ği (n= 6) ve di ğer se bep ola rak da mul ti or gan yet mez li ği (n= 5) idi. Kro nik tip A dis sek si yon ol gu la rın da has ta ne mor ta li te si 6.25% (3/48) idi. Ölüm se bep le ri; so...

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Preservation of the aortic valve in acute aortic dissection: Long-term echocardiographic assessment and clinical outcome

Cited by 91 publications

References 16 publications

When and how to replace the aortic root in type A aortic dissection

When and how to replace the aortic root in type A aortic dissection

Reimplantation Valve Sparing Procedure in Type A Aortic Dissection: A Predictive Factor of Mortality and Morbidity?

Supracommissural Aortic Replacement: A Reliable Option for Acute and Chronic Aortic Type A Dissection

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