Clinical outcomes of combined aortic root reimplantation technique and total arch replacement
| Autor: | Hitoshi Minami, Masamichi Matsumori, Kenji Okada, Hiroya Kano, Takeshi Inoue, Toshihito Sakamoto, Shunsuke Miyahara, Yutaka Okita |
|---|---|
| Rok vydání: | 2014 |
| Předmět: |
Male
Pulmonary and Respiratory Medicine Aortic arch Aortic valve Marfan syndrome medicine.medical_specialty medicine.medical_treatment Aortic Valve Insufficiency Aorta Thoracic Marfan Syndrome Aortic aneurysm Aneurysm medicine.artery medicine Humans Thoracic aorta Aortic dissection Mechanical ventilation business.industry General Medicine Middle Aged medicine.disease Aortic Aneurysm Surgery Aortic Dissection Treatment Outcome medicine.anatomical_structure Aortic Valve Replantation Anesthesia Female Cardiology and Cardiovascular Medicine business |
| Zdroj: | European Journal of Cardio-Thoracic Surgery. 48:152-157 |
| ISSN: | 1873-734X 1010-7940 |
| Popis: | OBJECTIVES: The goal of this study was to evaluate early and late outcomes of combined valve-sparing aortic root replacement and total arch replacement (TAR). METHODS: From October 1999 to May 2014, 195 patients underwent valve-sparing operations using the David reimplantation technique. Thirty-one patients underwent combined TAR for aortic regurgitation (AR) with extended aortic aneurysm from the aortic root to the aortic arch. Aetiologies included acute type A aortic dissection in 12 cases, chronic aortic dissection in 8 cases and non-dissecting aneurysm in 11 cases. There were 9 patients with Marfan syndrome. The preoperative severity of AR was mild in 4, moderate in 16 and severe in 11. Even though half of those were emergent operations for acute aortic dissection, preoperative haemodynamic conditions were stable in all patients. RESULTS: No hospital deaths occurred. Postoperative complications included prolonged mechanical ventilation (>48 h) in 1 case and re-exploration for bleeding in 2 cases. Other complications, such as neurological dysfunction or low cardiac output syndrome, were not observed. At hospital discharge, 2 patients had mild AR, 22 had trace AR and 7 had no AR. During follow-up, 2 patients had moderate AR, 7 had mild AR, 18 had trace AR and 3 had no AR. Follow-up was completed in 95.1% of patients, and the mean follow-up period was 60.5±9.1 months. No late death and thromboembolic complication occurred during follow-up. One patient required reoperation for AR. Freedom from reoperation at 5 and 10 years was 100±0 and 83.3±3.5%, respectively. Freedom from moderate or severe AR at 3 and 5 years was 83.3±3.5 and 83.3±3.5%, respectively. CONCLUSIONS: Early outcomes of combined aortic root reimplantation and TAR were satisfactory and provided excellent freedom from thromboembolic complication. The rate of freedom from reoperation during long-term follow-up was acceptable. Further follow-up is required to evaluate this procedure. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|