Loading...
Please wait, while we are loading the content...
Similar Documents
Long-term outcomes after valve-sparing anatomical aortic root reconstruction in acute dissection involving the root
| Content Provider | Scilit |
|---|---|
| Author | Irimie, Vadim Atieh, Alaa Kucinoski, Gjoko Jankulovski, Atanas Zacher, Michael Urbanski, Paul P. |
| Copyright Year | 2020 |
| Description | Journal: Journal of Thoracic and Cardiovascular Surgery To evaluate long-term results after valve-sparing surgery of acutely dissected aortic root in which a restoration of root anatomy adjusted to the existing aortic annulus diameter, rather than any kind of downsizing, was performed. Among 286 consecutive patients operated on because of type A aortic dissection during the last 17 years were 100 patients (35.0%), mean age 63 ± 13 years (range, 29-88 years), in whom an anatomical restoration of the involved root was performed. Twenty-eight patients presented with severe (3+ or 4+), 37 with mild to moderate (2+), and 24 with mild (1+) insufficiency. In 5 patients, the valve was bicuspid. In all patients, a curative root repair with replacement of all dissected aortic wall was performed, containing a selective replacement of pathologic/dissected aortic sinuses, which were 1, 2, or all 3 sinuses in 62, 32, and 6 patients, respectively. Concomitant cusp repair was necessary in 18 patients. Thirty-day mortality was 1.0%. Survival was estimated starting with surgery and was 89.4 ± 3.4% (95% confidence interval, 80.5-94.4) and 68.8 ± 6.4% (95% confidence interval, 54.4-79.5) at 5 and 12 years, respectively. No patient required reoperation on the aortic root and/or valve during the follow-up period of 70 ± 50 (range, 3-202) months. A freedom from any aortic valve/root reintervention and/or relevant (>2+) aortic insufficiency at 12 years was 100%. Selective replacement of pathologic sinuses offers an anatomophysiological albeit curative restoration of acutely dissected aortic root resulting in excellent and durable outcomes in selected patients with acute aortic dissection. |
| Related Links | http://www.jtcvs.org/article/S0022522319309316/pdf |
| ISSN | 00225223 |
| e-ISSN | 1097685X |
| DOI | 10.1016/j.jtcvs.2019.04.036 |
| Journal | Journal of Thoracic and Cardiovascular Surgery |
| Issue Number | 4 |
| Volume Number | 159 |
| Language | English |
| Publisher | Elsevier BV |
| Publisher Date | 2020-04-01 |
| Access Restriction | Open |
| Subject Keyword | Journal: Journal of Thoracic and Cardiovascular Surgery Aortic Dissection Aortic Root Aortic Valve Selective Sinus Replacement Valve-sparing Root Repair |
| Content Type | Text |
| Resource Type | Article |
| Subject | Pulmonary and Respiratory Medicine Surgery Cardiology and Cardiovascular Medicine |
