Document Detail


Aortic root aneurysm: principles of repair and long-term follow-up.
MedLine Citation:
PMID:  21092781     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: This study was undertaken to examine clinical and echocardiographic outcomes of aortic valve-sparing operations to treat aortic root aneurysms.
METHODS: From May 1988 to December 2007, a total of 228 patients underwent reimplantation of the aortic valve, and 61 underwent remodeling of the aortic root. Patients were followed up prospectively and had echocardiographic evaluation of valve function. Mean follow-up was 7.28 ± 4.33 years.
RESULTS: There were 5 operative and 26 late deaths. Survival at 12 years was 82.9 ± 3.7% and similar between types of operations. Age and aortic dissection were independent predictors of mortality. Seven patients have had reoperations on the aortic valve: 6 for aortic insufficiency and 1 for endocarditis. Five of these patients had undergone remodeling of the aortic root. Freedoms from reoperation at 12 years were 94.3% ± 2.6% among all patients, 90.4% ± 4.7% after remodeling, and 97.4% ± 2.2% after reimplantation (P = .09). Postoperatively, moderate aortic insufficiency developed in 14 patients (8 remodeling and 6 reimplantation) and severe aortic insufficiency in 5 (3 remodeling and 2 reimplantation). The remaining patients had mild, trace, or no aortic insufficiency. Freedoms from moderate or severe aortic insufficiency at 12 years were 86.8% ± 3.8% among all patients, 82.6% ± 6.2% after remodeling, and 91.0% ± 3.8% after reimplantation (P = .035). Only age-by 5-year increments-was an independent predictor of postoperative aortic insufficiency.
CONCLUSIONS: Aortic valve-sparing operations provide excellent patient survival and stable aortic valve function, particularly after reimplantation of the aortic valve.
Authors:
Tirone E David; Manjula Maganti; Susan Armstrong
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The Journal of thoracic and cardiovascular surgery     Volume:  140     ISSN:  1097-685X     ISO Abbreviation:  J. Thorac. Cardiovasc. Surg.     Publication Date:  2010 Dec 
Date Detail:
Created Date:  2010-11-24     Completed Date:  2010-12-20     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0376343     Medline TA:  J Thorac Cardiovasc Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  S14-9; discussion S45-51     Citation Subset:  AIM; IM    
Copyright Information:
Copyright © 2010 The American Association for Thoracic Surgery. Published by Mosby, Inc. All rights reserved.
Affiliation:
Division of Cardiovascular Surgery of Peter Munk Cardiac Centre, Toronto General Hospital and University of Toronto, Toronto, Ontario, Canada. tirone.david@uhn.on.ca
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Aged
Aortic Aneurysm / mortality,  physiopathology,  surgery*,  ultrasonography
Aortic Valve / physiopathology,  surgery*,  ultrasonography
Chi-Square Distribution
Child
Female
Follow-Up Studies
Humans
Kaplan-Meier Estimate
Male
Middle Aged
Ontario
Proportional Hazards Models
Prospective Studies
Reoperation
Replantation* / adverse effects,  mortality
Risk Assessment
Risk Factors
Surgical Procedures, Minimally Invasive
Survival Rate
Time Factors
Treatment Outcome
Vascular Surgical Procedures* / adverse effects,  mortality
Young Adult

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