Techniques of Proximal Root Reconstruction and Outcomes Following Repair of Acute Type A Aortic Dissection
| Autor: | Kamal R. Khabbaz, Nicholas T. Kouchoukos, Lawrence H. Patzelt, Kevin W. Lobdell, Sotiris C. Stamou, Robert Hagberg, Tyler M. Gunn |
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| Rok vydání: | 2014 |
| Předmět: |
Aortic valve
Aortic dissection medicine.medical_specialty Aorta business.industry Bentall procedure medicine.disease Surgery Aortic aneurysm medicine.anatomical_structure Aortic valve replacement Acute type Concomitant medicine.artery Internal medicine medicine Cardiology Radiology Nuclear Medicine and imaging Original Research Article Cardiology and Cardiovascular Medicine business |
| Zdroj: | Aorta (Stamford, Conn.). 4(2) |
| ISSN: | 2325-4637 |
| Popis: | Background: The goal of this study was to compare the early and late outcomes of different techniques of proximal root reconstruction during the repair of acute Type A aortic dissection, including aortic valve (AV) resuspension, aortic valve replacement (AVR), and a root replacement procedure. Methods: All patients who underwent acute Type A aortic dissection repair between January 2000 and October 2010 at four academic institutions were compiled from each institution’s Society of Thoracic Surgeons Database. This included 189 patients who underwent a concomitant aortic valve (AV) procedure; 111, 21, and 57 patients underwent AV resuspension, AVR, and the Bentall procedure, respectively. The median age of patients undergoing a root replacement procedure was significantly younger than the other two groups. Early clinical outcomes and 10-year actuarial survival rates were compared. Trends in outcomes and surgical techniques throughout the duration of the study were also analyzed. Results: The operative mortality rates were 17%, 29%, and 18%, for AV resuspension, AVR, and root replacement, respectively. Operative mortality (p = 0.459) was comparable between groups. Hemorrhage related re-exploration did not differ significantly between groups (p = 0.182); however, root replacement procedures tended to have decreased rates of bleeding when compared to AVR (p = 0.067). The 10-year actuarial survival rates for the AV resuspension, Bentall, and AVR groups were 72%, 56%, and 36%, respectively (log-rank p = 0.035). Conclusions: The 10-year actuarial survival was significantly lower in those receiving AVR compared to those receiving root replacement procedures or AV resuspension. Operative mortality was comparable between the three groups. |
| Databáze: | OpenAIRE |
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