| Aortic root replacement in patients with previous heart surgery. | |
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MedLine Citation:
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PMID: 15245462 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: The objective was to review the operative risk and outcomes of redo aortic root replacement. PATIENTS AND METHODS: From July 1990 to December 2001, aortic root replacement was performed in 165 patients who had at least one previous cardiac operation. Their mean age was 49 +/- 16 years and 78% were men. Twenty-eight patients had a previous aortic root replacement. The principal indication for surgery was prosthetic aortic valve dysfunction. All the patients had a dilated, calcified, ruptured, or some other abnormality of the aortic root. The follow-up was complete and extended from 0 to 12.5 years, mean of 3.8 years. RESULTS: There were 12 operative (7%) and 20 late deaths (12%). The survival at 8 years was 68%+/- 6%. The principal cause of death was cardiovascular related. Age at increments of 5 years (risk ratio: 1.2; CI: 95%; 1.1 to 1.4) and preoperative New York Heart Association functional class IV (risk ratio: 2.2; CI: 95%: 1.1 to 4.7) were the only two independent predictors of death. Two patients had a stroke and died; two patients developed three episodes of prosthetic valve endocarditis and died. Three patients were reoperated on because of endocarditis in one, bioprosthetic valve failure in one, and dehiscence of a prosthetic mitral valve in one. The freedom from reoperation at 8 years was 93%+/- 5%. CONCLUSIONS: Redo aortic root replacement can be done with low operative mortality in elective patients and the risk increases in those who need emergent surgery and are older. The long-term results are satisfactory and similar to those for patients who have aortic root replacement for the first time. |
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Authors:
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Tirone E David; Christopher M Feindel; Joan Ivanov; Susan Armstrong |
Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Journal of cardiac surgery Volume: 19 ISSN: 0886-0440 ISO Abbreviation: J Card Surg Publication Date: 2004 Jul-Aug |
Date Detail:
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Created Date: 2004-07-12 Completed Date: 2004-11-30 Revised Date: 2007-11-15 |
Medline Journal Info:
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Nlm Unique ID: 8908809 Medline TA: J Card Surg Country: United States |
Other Details:
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Languages: eng Pagination: 325-8 Citation Subset: IM |
Affiliation:
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Division of Cardiovascular Surgery of Toronto General Hospital and University of Toronto, Toronto, Ontario, Canada. tirone.david@uhn.on.ca |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Aged Aorta, Thoracic / pathology, surgery* Aortic Valve / pathology, surgery* Cardiopulmonary Bypass Female Heart Valve Diseases / surgery* Heart Valve Prosthesis Implantation / methods* Humans Male Middle Aged Postoperative Complications / mortality Reoperation / mortality Retrospective Studies Stroke / etiology Survival Analysis Treatment Outcome |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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