Stentless root bioprosthesis for repair of acute type A aortic dissection
Autor: | Robert L. Hooker, Charles C. Willekes, Craig R. Smith, Sotiris C. Stamou, John Heiser, Lawrence H. Patzelt, Edward T. Murphy |
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Rok vydání: | 2013 |
Předmět: |
Adult
Male Pulmonary and Respiratory Medicine medicine.medical_specialty Transplantation Heterologous Hemodynamics Aorta Thoracic Femoral artery Dissection (medical) law.invention law medicine.artery Cardiopulmonary bypass Medicine Humans In patient Aged Retrospective Studies Aortic dissection Aged 80 and over Bioprosthesis Heart Valve Prosthesis Implantation Cardiopulmonary Bypass Aortic Aneurysm Thoracic business.industry Operative mortality Middle Aged medicine.disease Surgery Survival Rate Aortic Dissection Treatment Outcome Acute type Aortic Valve Heart Valve Prosthesis Female business Cardiology and Cardiovascular Medicine Vascular Surgical Procedures |
Zdroj: | The Journal of Thoracic and Cardiovascular Surgery. 145(6):1540-1544 |
ISSN: | 0022-5223 |
DOI: | 10.1016/j.jtcvs.2012.05.029 |
Popis: | Objective The superior hemodynamics and excellent long-term clinical performance of stentless xenografts are well described. However, the early and midterm clinical outcomes of stentless valves in patients with acute type A dissection are widely unknown. The current study evaluated the early and midterm clinical outcomes of stentless bioprosthesis for repair of acute type A aortic dissection. Methods Between May 2005 and December 2009, 24 of 80 patients underwent root replacement using the Medtronic Freestyle xenograft (Medtronic Inc, Minneapolis, Minn) at the Meijer Heart Center. Prospective data collection was used for retrospective review. Univariate comparisons of preoperative, intraoperative, and postoperative variables were performed between patients who underwent stentless root bioprosthesis for the correction of acute type A aortic dissection (n = 24). Results The mean age of patients was 57 years, with 15 patients aged less than 65 years. Axillary and femoral artery cannulation were used in 16 patients (67%) and 7 patients (29%), respectively. Median crossclamp and cardiopulmonary bypass times were 198 minutes (92-480 minutes) and 288 minutes (109-588 minutes), respectively. Median circulatory arrest time was 28 minutes (24-50 minutes). Operative mortality rate was 25%. Actuarial 5-year survival was 62.5%. No patients required redo aortic root replacement. Conclusions Stentless valve implantation can be accomplished with satisfactory early and midterm clinical outcomes and is a valuable option in patients with acute aortic dissection who require root replacement. |
Databáze: | OpenAIRE |
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