|Early results of valve-sparing reimplantation procedure using the Valsalva conduit: a multicenter study.|
|PMID: 16928499 Owner: NLM Status: MEDLINE|
|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.|
|Davide Pacini; Fabrizio Settepani; Ruggero De Paulis; Antonino Loforte; Saverio Nardella; Diego Ornaghi; Roberto Gallotti; Luigi Chiariello; Roberto Di Bartolomeo|
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|Type: Evaluation Studies; Journal Article; Multicenter Study|
|Title: The Annals of thoracic surgery Volume: 82 ISSN: 1552-6259 ISO Abbreviation: Ann. Thorac. Surg. Publication Date: 2006 Sep|
|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|
|Languages: eng Pagination: 865-71; discussion 871-2 Citation Subset: AIM; IM|
|Cardiac Surgery Department, S. Orsola-Malpighi Hospital, University of Bologna, Bologna. email@example.com|
|APA/MLA Format Download EndNote Download BibTex|
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
Intestines / blood supply
Ischemia / etiology, mortality
Marfan Syndrome / complications, surgery
Multiple Organ Failure / etiology, mortality
Postoperative Complications / mortality
Replantation* / methods, statistics & numerical data
Sinus of Valsalva / surgery*
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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