Document Detail


Aortic root replacement in patients with previous heart surgery.
MedLine Citation:
PMID:  15245462     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
Tirone E David; Christopher M Feindel; Joan Ivanov; Susan Armstrong
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of cardiac surgery     Volume:  19     ISSN:  0886-0440     ISO Abbreviation:  J Card Surg     Publication Date:    2004 Jul-Aug
Date Detail:
Created Date:  2004-07-12     Completed Date:  2004-11-30     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  8908809     Medline TA:  J Card Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  325-8     Citation Subset:  IM    
Affiliation:
Division of Cardiovascular Surgery of Toronto General Hospital and University of Toronto, Toronto, Ontario, Canada. tirone.david@uhn.on.ca
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MeSH Terms
Descriptor/Qualifier:
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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