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- Title
Root graft substitution after aortic valve replacement: sparing the valve prosthesis is a valid option.
- Authors
Di Eusanio, Marco; Berretta, Paolo; Cefarelli, Mariano; Di Bartolomeo, Roberto
- Abstract
OBJECTIVES Few case studies have shown the feasibility of the prosthesis-sparing operation in patients requiring aortic root replacement after aortic valve replacement. Such technique allows the sparing of a well-functioning aortic valve prosthesis and facilitates the root substitution with only a vascular graft. The aim of the present study was to assess short- and mid-term outcomes of the patients who underwent such procedures at our institution. METHODS Between 2004 and 2012, 26 patients (mean age: 59 ± 13.6 years; male: 21, 80.8%) underwent the prosthesis-sparing operation in our institution. The mean time from previous aortic intervention was 20.1 ± 6.9 years; two patients were operated for a Type A acute aortic dissection. RESULTS Overall, two patients (7.7%) died during hospitalization: both were operated for a complicated Type A acute aortic dissection. None of the electively operated patients died or presented serious complications after surgery, except for one patient (3.8%) who required chest re-exploration for excessive bleeding due to coagulopathy. At follow-up (100% completed at 30 ± 24 months) two late deaths occurred: one due to lung cancer and one due to infective endocarditis. Kaplan-Meier estimates of 1- and 3-year survival were 92 and 85.4%, respectively. No late cardiac/aortic re-interventions were performed during follow-up, with a 5-year freedom from re-operation of 100%. CONCLUSIONS Our favourable short- and mid-term results indicate that the prosthesis-sparing operation is a valid treatment option in selected re-operative aortic root procedures.
- Subjects
AORTIC valve surgery; AORTIC valve diseases; PROSTHETICS; VASCULAR grafts; AORTIC dissection; SURGICAL complications; HEALTH outcome assessment; PATIENTS
- Publication
European Journal of Cardio-Thoracic Surgery, 2013, Vol 44, Issue 3, p427
- ISSN
1010-7940
- Publication type
Article
- DOI
10.1093/ejcts/ezt034