Outcomes of aortic root enlargement during isolated aortic valve replacement

Autor:	Emily Shih, J. Michael DiMaio, John J. Squiers, Gelareh Rahimighazikalayeh, Talia C. Meidan, William T. Brinkman, Katherine B. Harrington, Justin M. Schaffer, William H. Ryan, Michael J. Mack
Rok vydání:	2022
Předmět:	Pulmonary and Respiratory Medicine Heart Valve Prosthesis Implantation Aortic Valve Stenosis Transcatheter Aortic Valve Replacement Postoperative Complications Treatment Outcome Risk Factors Aortic Valve Animals Humans Surgery Cattle Female Hospital Mortality Cardiology and Cardiovascular Medicine Propensity Score
Zdroj:	Journal of cardiac surgeryREFERENCES. 37(8)
ISSN:	1540-8191
Popis:	Aortic root enlargement (ARE) lowers the risk of patient prosthesis mismatch after surgical aortic valve replacement (SAVR) in patients with small annular size. Whether ARE is associated with increased operative mortality is controversial. This study compares the early and intermediate outcomes in patients undergoing SAVR with and without ARE.All patients undergoing isolated SAVR with and without ARE from 2015 to 2020 were analyzed. Propensity-matching was used to adjust for possible confounding variables. Kaplan-Meier analysis and log-rank test were used to estimate and compare overall outcomes and survival in the study cohorts.Among 868 isolated SAVRs, ARE was performed in 54 (6.2%) patients. Before matching, mean age was similar but female sex (67.4% vs. 29.6%; SD: -0.82) and previous AVR (18.9% vs. 3.9%; SD: -0.48) were more common in patients undergoing SAVR + ARE versus SAVR alone. A bovine pericardial patch was used for 81.5% (44 of 54) of ARE, with a Dacron patch in the rest. After propensity matching, the average cardiopulmonary bypass (138.2 ± 34.9 vs. 102.9 ± 33.0 min; p 0.01) and cross-clamp times (113.8 ± 26.7 vs. 83.0 ± 28.4 min; p 0.01) were longer in the SAVR + ARE group. There were no significant differences in postoperative stroke, new-onset dialysis, pacemaker placement, reoperation for bleeding, length of hospital stay, or 30-day readmission. Thirty-day mortality (0% vs. 0.6%, p = 1.0) and 5-year survival (96.3% vs. 95.7%, p = 0.86) were also similar.ARE during surgical AVR can be safely performed without an increase in complications with excellent early and intermediate-term survival.
Databáze:	OpenAIRE
Externí odkaz:	https://explore.openaire.eu/search/publication?articleId=doi_dedup___::be010c29b89614b6cd84bce62f5850db https://pubmed.ncbi.nlm.nih.gov/35598292 Zobrazit plný text záznamu Plný text ve formátu PDF Plný text ve formátu HTML
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