Document Detail


Does preoperative degree of aortic insufficiency influence early and midterm results of sparing surgery?
MedLine Citation:
PMID:  19476108     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: Aortic valve-sparing operations have shown excellent results in patients with aortic root and or ascending aorta aneurysm. Aortic valve regurgitation is frequently detected in these patients as a result of significant dilation of the aortic root.The aim of this study was to assess the impact of preoperative aortic incompetence degree on the early and midterm outcomes of sparing surgery. METHODS: From September 2001 to July 2006, 84 patients with aortic root aneurysm underwent aortic valve-sparing surgery according to the reimplantation technique. Depending on preoperative grade of aortic insufficiency (AI), two groups were identified: 31 patients (study group, SG) with AI grade III-IV and 53 (control group, CG) with AI grade II or less. The Gelweave Valsalva prosthesis was used in 76 patients (90.5%). Intraoperative, perioperative variables and outcomes at follow-up were retrospectively compared between the groups. RESULTS: Patient demographics and types of operations were comparable between groups. Early mortality rates were almost identical in both groups (3.2% SG vs. 5.7% CG; P = 0.961); at follow-up (FU), no patient died in both groups. Grade III-IV AI was similar in both groups early postoperatively (6.4% SG vs. 3.8% CG; P = 0.981) and during follow-up (13.3% vs. 8%; P = 0.755). Reoperaton rate for AI was 3.3% in SG vs. 6% in CG (P = 0.980). CONCLUSIONS: Preoperative degree of aortic regurgitation does not impair the outcomes of the valve-sparing operation which seem to depend on more factors. Early results were affected by the learning curve but midterm outcomes showed a progressive improvement. Patients with satisfactory reconstruction show stable results over time.
Authors:
Davide Pacini; Luca Botta; Giovanni Bracchetti; Francesco Massi; Luca Di Marco; Iolter Cattabriga; Roberto Di Bartolomeo
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Acta cardiologica     Volume:  64     ISSN:  0001-5385     ISO Abbreviation:  Acta Cardiol     Publication Date:  2009 Apr 
Date Detail:
Created Date:  2009-05-29     Completed Date:  2009-06-23     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0370570     Medline TA:  Acta Cardiol     Country:  Belgium    
Other Details:
Languages:  eng     Pagination:  171-6     Citation Subset:  IM    
Affiliation:
Cardiothoracovascular Department, University of Bologna, S. Orsola-Malpighi Hospital, Bologna, Italy. dpacini@hotmail.com
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MeSH Terms
Descriptor/Qualifier:
Aortic Valve / surgery*,  ultrasonography
Aortic Valve Insufficiency / physiopathology,  surgery,  ultrasonography*
Blood Flow Velocity / physiology*
Echocardiography, Doppler, Color / methods
Echocardiography, Transesophageal / methods*
Female
Follow-Up Studies
Heart Valve Prosthesis Implantation / methods*
Humans
Male
Middle Aged
Preoperative Care*
Replantation / methods*
Retrospective Studies
Time Factors
Treatment Outcome

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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