Document Detail


Early results of valve-sparing reimplantation procedure using the Valsalva conduit: a multicenter study.
MedLine Citation:
PMID:  16928499     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: This study evaluates the midterm clinical results of valve-preserving aortic root reconstruction by means of a modified conduit incorporating sinuses of Valsalva. METHODS: During a 5-year period, 151 patients with aneurysm of the aortic root underwent a reimplantation type of valve-sparing procedure using the Gelweave Valsalva prosthesis that incorporates sinuses of Valsalva. There were 121 males (80.1%), and the mean age was 56.4 +/- 14.4 years (range, 14 to 83). Fourteen percent of the patients had Marfan syndrome and 8.6% had bicuspid aortic valve. Seven patients (4.6%) suffered from acute aortic dissection. Aortic replacement was extended to the arch in 14 patients (9.3%). Sixteen patients (10.6%) had associated cusp repair. RESULTS: In-hospital mortality was 3.3%, and it was significantly higher among patients operated on for acute dissection (p = 0.001) and in symptomatic patients (III-IV New York Heart Association class; p = 0.021). Follow-up (mean, 18 months; range, 1 to 60) was 100% complete. There were 2 late deaths. Ten patients (6.8%) had 3 to 4+ aortic regurgitation, and 8 of these required late aortic valve replacement. Cusp repair was associated with a high incidence of late aortic valve replacement (p = 0.005). At 5 years, freedom from aortic valve replacement and freedom from grade 3 to 4 aortic insufficiency was 90.8% +/- 3.3% and 88.7% +/- 3.6%, respectively. CONCLUSIONS: The reimplantation valve-sparing procedure with the Gelweave Valsalva prosthesis provides satisfactory results for patients with aortic root aneurysm. Aortic cusp repair may lead to late aortic insufficiency. Proper leaflet evaluation is of paramount importance in preventing residual valve regurgitation.
Authors:
Davide Pacini; Fabrizio Settepani; Ruggero De Paulis; Antonino Loforte; Saverio Nardella; Diego Ornaghi; Roberto Gallotti; Luigi Chiariello; Roberto Di Bartolomeo
Related Documents :
20437359 - Latest advances in transcatheter aortic valve implantation.
20718199 - Quadricuspid aortic valve diagnosed by transthoracic echocardiography in childhood.
20022869 - Pitfalls of anatomical aortic valve area measurements using two-dimensional transoesoph...
9330169 - Prediction of stentless aortic bioprosthesis size with transesophageal echocardiography...
16725339 - Twenty years experience of surgical aortic valvotomy for critical aortic stenosis in ea...
20641109 - An asymtomatic unicuspid aortic valve with aortic aneurysm and secundum type atrial sep...
431109 - False aneurysm of right pulmonary artery. new complication of aorta-right pulmonary art...
16418239 - Multi-detector row ct of hemoptysis.
23407289 - Treatment of posterior circulation aneurysms with the pipeline embolization device.
Publication Detail:
Type:  Evaluation Studies; Journal Article; Multicenter Study    
Journal Detail:
Title:  The Annals of thoracic surgery     Volume:  82     ISSN:  1552-6259     ISO Abbreviation:  Ann. Thorac. Surg.     Publication Date:  2006 Sep 
Date Detail:
Created Date:  2006-08-24     Completed Date:  2006-09-13     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  15030100R     Medline TA:  Ann Thorac Surg     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  865-71; discussion 871-2     Citation Subset:  AIM; IM    
Affiliation:
Cardiac Surgery Department, S. Orsola-Malpighi Hospital, University of Bologna, Bologna. dpacini@hotmail.com
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Aged
Aged, 80 and over
Aneurysm, Dissecting / surgery
Aorta / surgery*
Aortic Aneurysm / etiology,  surgery*
Aortic Valve / abnormalities,  surgery*
Aortic Valve Insufficiency / epidemiology
Cardiac Output, Low / etiology,  mortality
Equipment Design
Female
Follow-Up Studies
Hospital Mortality
Humans
Intestines / blood supply
Ischemia / etiology,  mortality
Male
Marfan Syndrome / complications,  surgery
Middle Aged
Multiple Organ Failure / etiology,  mortality
Postoperative Complications / mortality
Prosthesis Failure
Replantation* / methods,  statistics & numerical data
Sinus of Valsalva / surgery*
Survival Analysis
Treatment Outcome

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


Previous Document:  How to deal with recipients of valves prone to structural failure in the 2000s: Padua experience wit...
Next Document:  Endovascular repair of thoracic aortic tears.