Surgical repair of aortic root aneurysms in 280 patients

Lewis, Clifton; Cooley, Denton A.; Murphy, Michael C.; Talledo, Oscar; Vega, David

doi:10.1016/0003-4975(92)90755-s

Cited by 98 publications

(37 citation statements)

References 19 publications

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“…4,10,15,16 In most published series the longerterm survival figures for AVR are Ϸ80% to 85% at 5 years, 65% to 75% at 10 years, 45% to 55% at 15 years and for CVG 70% to 80% at 5 years, 60% to 70% at 10 years and 50% to 65% at 15 years, respectively. 4,6,10,15,17,18 The survivals reported in this national cohort study are similar. In common with single center reports, we found a high rate of freedom from reoperation for both AVR and CVG at 10 years with a similar time to reoperation.…”

Section: Kalkat Et Al Composite Aortic Valve Graft Replacement Outcomsupporting

confidence: 64%

Composite Aortic Valve Graft Replacement

Kalkat

Edwards²,

Taylor³

et al. 2007

Circulation

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Section: Kalkat Et Al Composite Aortic Valve Graft Replacement Outcomsupporting

confidence: 64%

Composite Aortic Valve Graft Replacement

Kalkat

Edwards²,

Taylor³

et al. 2007

Circulation

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“…The main conceptual difference of surgical techniques for aortic root lies in the use of a valved conduit or the aortic valve preservation, with their respective advantages and disadvantages. Since Bentall & De Bono [1] introduced the operation to replace the ascending aorta and the aortic valve for a valved conduit, several adaptations to this original technique have been proposed [2][3][4][5]. After mastering these operations, as an alternative, another concept for the treatment of this aortic segment arose, and it would be replaced associated with the aortic valve preservation.…”

Section: Introductionmentioning

confidence: 99%

Análise do tratamento cirúrgico da raiz da aorta com o tubo valvulado e com a preservação da valva aórtica

Dias¹,

Mejía²,

Fiorelli³

et al. 2010

Rev Bras Cir Cardiovasc

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Análise do tratamento cirúrgico da raiz da aorta com o tubo valvulado e com a preservação da valva aórticaAnalysis of aortic root surgery with composite mechanical aortic valve conduit and valve-sparing reconstruction 7. Faculty Member of Cardiovascular Surgery Discipline at InCor-FMUSP; CEO of InCor-FMUSP Hospital.Work performed at the Heart Institute, School of Medicine, University of Sao Paulo (InCor-FMUSP), Sao Paulo, SP, Brazil. Sixteen percent of patients had Marfan syndrome and 4.3% had bicuspid aortic valve. One hundred and forty-four patients (88%) were followed for a mean period of 41.1 ± 20.8 months.Results: The hospital mortality was 4.9%, 5.6% in operations with valved conduits and 2.6% in the valve sparing procedures (P <0.05). There was no difference neither in survival (95% CI = 86% -96%, P= 0.1) nor in reoperationfree survival (95% CI = 85% -90%, P = 0.29). The survival free of complications such as bleeding, thromboembolism and endocarditis were favorable to the valve sparing operations, respectively (95% CI = 70% -95%, P = 0.001), (95% CI = 82% -95% P = 0.03) and (95% CI = 81% -95%, P = 0.03). Multivariate analysis showed that creatinine greater than 1.4 mg/dl, Cabrol operation and renal dialysis were predictors of mortality, respectively, with occurrence chance of 6 (95% CI = 1.8 -19.5, P = 0.003), 12 (95% CI = 3 -49.7, P = 0.0004) and 16 (95% CI = 3.6 -71.3, P = 0.0002).Conclusions: The aortic root reconstruction has a low early and late mortality, high survival free of complications and low need for reoperation. During the late follow-up, valve sparing aortic root reconstructions presented fewer incidences of bleeding, thromboembolic events and endocarditis.Descriptors: Aorta. Aortic aneurysm, thoracic. Aortic valve insufficiency. Aortic valve. DIAS, RR ET AL -Analysis of aortic root surgery with composite mechanical aortic valve conduit and valve-sparing reconstruction Rev Bras Cir Cardiovasc 2010; 25(4): 491-499

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“…[5][6][7][8] In an attempt to avoid anticoagulation in this relatively young patient population, Sarsam and Yacoub 9 and David and Feindel 10 have described valve-preserving aortic root reconstruction techniques. Despite the fact that the valve cusps often appear functionally normal, there is evidence that they have abnormalities similar to those in the aortic wall tissue, [11][12][13] potentially limiting their durability.…”

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confidence: 99%

Surgery for Aneurysms of the Aortic Root

et al. 2004

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Background-This study evaluated long-term results of aortic root replacement and valve-preserving aortic root reconstruction for patients with aneurysms involving the aortic root. Methods and Results-Two-hundred three patients aged 53Ϯ16 years (meanϮSD; 153 male, 50 female) underwent elective or urgent aortic root surgery from 1971 to 2000 for an aortic root aneurysm: 149 patients underwent a composite valve conduit reconstruction, and 54 patients underwent valve-preserving aortic root reconstruction. Fifty patients had Marfan syndrome. In-hospital and 30-day mortality was 4.0% (8/203) overall: for a composite valve conduit procedure, the corresponding value was 4.0% (6/149) and for valve-preserving procedure, 3.7% (2/54) (PϭNS). Morbidity included 3 strokes (1%), 10 perioperative myocardial infarctions (5%), and 8 reoperations for bleeding (4%). Actuarial survival at 5, 10, 15, and 20 years was 93% (95% confidence interval [CI] ϭ 88% to 97%), 79% (95% CI ϭ 71% to 87%), 67% (95% CI ϭ 57% to 79%), and 52% (95% CI ϭ 36% to 69%), respectively. Freedom from reoperation was 72% (95% CI ϭ 54% to 86%) at 20 years. Complications with anticoagulation occurred in 29 patients; with valve thrombosis, in 2; and with hemorrhage, in 27 (4 life threatening and 23 minor). Freedom from thromboembolism was 91% (95% CI ϭ 77% to 98%) at 20 years. Freedom from endocarditis was 99% (95% CI ϭ 92% to 100%) at 20 years. Multivariate analysis revealed preoperative mitral valve regurgitation (ϩ3 to 4) and older age to be significant predictors of late death (PՅ0.005), and Marfan syndrome, initial valve-preserving aortic root reconstruction, and need for a concomitant procedure at initial operation to be significant predictors of the need for reoperation (PՅ0.01). Conclusions-Aortic root replacement for aortic root aneurysms can be done with low morbidity and mortality. Composite valve conduit reconstruction resulted in a durable result. There were few serious complications related to the need for long-term anticoagulation or a prosthetic valve. Reoperation was most commonly required because of failure of the aortic valve when a valve-preserving aortic root reconstruction was performed or for other cardiac or aortic disease elsewhere.

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Surgical repair of aortic root aneurysms in 280 patients

Cited by 98 publications

References 19 publications

Composite Aortic Valve Graft Replacement

Composite Aortic Valve Graft Replacement

Análise do tratamento cirúrgico da raiz da aorta com o tubo valvulado e com a preservação da valva aórtica

Surgery for Aneurysms of the Aortic Root

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