Loading...
Please wait, while we are loading the content...
A progress report on reimplantation of the aortic valve
| Content Provider | Scilit |
|---|---|
| Author | David, Tirone E. David, Carolyn M. Ouzounian, Maral Feindel, Christopher M. Lafreniere-Roula, Myriam |
| Copyright Year | 2020 |
| Description | Journal: Journal of Thoracic and Cardiovascular Surgery Objective To examine the late outcomes of reimplantation of the aortic valve (RAV) in patients followed prospectively since surgery. Methods All 465 patients who had RAV from 1989 to 2018 were followed prospectively with periodic clinical and echocardiographic assessments. Mean follow-up was 10 ± 6 years and 98% complete. Results Patients' mean age was 47 ± 5.1 years, and 78% were men. The aortic root aneurysm was associated with Marfan syndrome in 164 patients, Loeys–Dietz syndrome in 13, bicuspid aortic valve (BAV) in 67, and type A aortic dissection in 33. Aortic insufficiency (AI) was greater than mild in 298 patients. Concomitant procedures were performed in 105 patients. There were 5 operative and 51 late deaths. At 20 years, 69.1% of patients were alive and free from aortic valve reoperation, and the cumulative probability of aortic valve reoperation with death as a competing risk was 6.0%, and the cumulative probability of developing moderate or severe AI was 10.2%. Only time per 1-year interval was associated with the development of postoperative AI by multivariable analysis (hazard ratio, 1.06; 95% confidence interval, >1.02-1.10; P = .006). Gradients across preserved BAV increased in 5 patients, and 1 required reoperation for aortic stenosis. Distal aortic dissections occurred in 22 patients, primarily in those with associated genetic syndromes. Conclusions RAV provides excellent long-term results, but there is a progressive rate of AI over time, and patients with BAV may develop aortic stenosis. Patients with genetic syndromes have a risk of distal aortic dissections. Continued surveillance after RAV is necessary. |
| Related Links | http://www.jtcvs.org/article/S0022522320325605/pdf |
| ISSN | 00225223 |
| e-ISSN | 1097685X |
| DOI | 10.1016/j.jtcvs.2020.07.121 |
| Journal | Journal of Thoracic and Cardiovascular Surgery |
| Issue Number | 3 |
| Volume Number | 161 |
| Language | English |
| Publisher | Elsevier BV |
| Publisher Date | 2020-09-04 |
| Access Restriction | Open |
| Subject Keyword | Journal: Journal of Thoracic and Cardiovascular Surgery Aortic Valve–sparing Operation Reimplantation of the Aortic Valve Aortic Root Aneurysm Aortic Insufficiency Bicuspid Aortic Valve Confidence Interval Interquartile Range |
| Content Type | Text |
| Resource Type | Article |
| Subject | Pulmonary and Respiratory Medicine Surgery Cardiology and Cardiovascular Medicine |
