Document Detail

Composite valve graft replacement of the aortic root: twenty-seven years of experience at one Japanese center.
MedLine Citation:
PMID:  19049741     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: The aim of this study was to evaluate the early and long-term results of a composite valve graft root replacement for various aortic root diseases. METHODS: Between 1978 and 2005, 273 patients with various disorders of the aortic root underwent a composite valve graft root replacement. The mean age of the patients was 47.5 +/- 13.2 years. There were 93 patients with Marfan syndrome, 56 aortitis, and 63 type A aortic dissections. Thirty-nine emergency operations and 55 redo operations were included. For the proximal anastomosis, a skirted technique was used in 157 patients. For the coronary reconstruction, Bentall's original inclusion technique was utilized in 36 patients, a direct button technique in 159, and a graft interposition technique in 63. The mean follow-up was 106 months. RESULTS: The in-hospital mortality was 9.5%. An emergency operation emerged as a significant predictor of early death. The actuarial survival rate was 87.0% and 72.9% at 5 and 15 years, respectively. The age at the operation, aortitis, Marfan syndrome, and use of a standard proximal anastomosis emerged as independent determinants of late death. The actuarial reoperation free rate was 96.3% and 89.7% at 5 and 15 years, respectively. In the patients who underwent the skirted technique the incidence of late graft detachment was less frequent than that of the standard technique. CONCLUSIONS: A composite valve graft root replacement is a safe and reliable procedure for various aortic root diseases with stable early- and long-term results. The skirted technique seems to be attractive to avoid late graft detachment even in cases with a fragile inflammatory pathology.
Tomohiro Tsunekawa; Hitoshi Ogino; Hitoshi Matsuda; Kenji Minatoya; Hiroaki Sasaki; Junjiro Kobayashi; Toshikatsu Yagihara; Soichiro Kitamura
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The Annals of thoracic surgery     Volume:  86     ISSN:  1552-6259     ISO Abbreviation:  Ann. Thorac. Surg.     Publication Date:  2008 Nov 
Date Detail:
Created Date:  2008-12-03     Completed Date:  2009-02-05     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  15030100R     Medline TA:  Ann Thorac Surg     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  1510-7     Citation Subset:  AIM; IM    
Department of Cardiothoracic Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan.
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MeSH Terms
Aneurysm, Dissecting / mortality,  surgery*
Anticoagulants / adverse effects
Aortic Aneurysm / mortality,  surgery*
Aortitis / surgery
Confidence Intervals
Disease-Free Survival
Heart Valve Prosthesis Implantation* / adverse effects,  mortality
Hemorrhage / etiology
Marfan Syndrome / mortality,  surgery*
Middle Aged
Surgical Wound Infection / etiology
Survival Rate
Thromboembolism / etiology
Reg. No./Substance:

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