Outcomes of reoperative aortic root surgery
| Autor: | Derek Serna-Gallegos, Danny Chu, Sadie Longo, Ibrahim Sultan, Courtenay Dunn-Lewis, James A. Brown, Forozan Navid, Arman Kilic |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
Pulmonary and Respiratory Medicine
medicine.medical_specialty Aorta business.industry Aortic root Retrospective cohort study medicine.disease Surgery law.invention Aortic aneurysm law Infective endocarditis medicine.artery Propensity score matching cardiovascular system Cardiopulmonary bypass Medicine In patient Cardiology and Cardiovascular Medicine business |
| Zdroj: | The Journal of Thoracic and Cardiovascular Surgery. |
| ISSN: | 0022-5223 |
| Popis: | Objective The study objective was to determine the impact of reoperative aortic root replacement on short-term outcomes and survival. Methods This was a retrospective study of aortic root operations from 2010 to 2018. All patients with a complete aortic root replacement were included, and patients undergoing valve-sparing root replacements were excluded. Patients were dichotomized by first-time sternotomy versus redo sternotomy, which was defined as having had a prior sternotomy for whatever reason. Within the redo sternotomy group, reoperative aortic root replacements were identified, being defined as a complete aortic root replacement in patients with a prior aortic root replacement; 1:1 nearest neighbor propensity matching was used to compare outcomes across groups. Kaplan–Meier survival estimates were generated and compared using log-rank statistics. Results A total of 893 patients undergoing complete ARR were identified, of whom 595 (67%) underwent first-time sternotomy and 298 (33%) underwent redo sternotomy. After matching, postoperative outcomes were similar for the first-time and redo sternotomy groups, including operative mortality. Redo sternotomy was not associated with reduced survival after aortic root replacement compared with first-time sternotomy (P = .084), with 5-year survival of 73.7% for first-time sternotomy and 72.9% for redo sternotomy. In the redo sternotomy group (n = 298), 69 (23%) were reoperative aortic root replacements and 229 (77%) were first-time aortic root replacements. After matching, postoperative outcomes were similar for the first-time and reoperative aortic root replacement groups, including operative mortality. Reoperative aortic root replacement was not associated with reduced survival, compared with first-time aortic root replacement (P = .870), with 5-year survival of 67.9% for first-time aortic root replacement and 72.1% for reoperative aortic root replacement. Conclusions Reoperative aortic root replacement can be performed safely and provides similar survival to first-time aortic root replacement. |
| Databáze: | OpenAIRE |
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