Document Detail


Fate of the aortic valve after root reconstruction in type A aortic dissection: a 20-year follow up.
MedLine Citation:
PMID:  20099691     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND AND AIM OF THE STUDY: The study aim was to evaluate the fate of the aortic valve after root reconstruction in acute type A aortic dissection. METHODS: Between 1982 and 2006, a total of 373 consecutive patients underwent emergency surgery for acute type A aortic dissection at the authors' institution. Of these patients, 298 (mean age 63 +/- 11 years; range: 22-85 years) underwent replacement of the supracoronary aorta with root reconstruction. The mean follow up period was 6.9 +/- 5.2 years (range: 2 months to 23 years), and was 98% complete. Aortic valve function was assessed by the incidence of aortic valve reoperation and transthoracic echocardiography. RESULTS: The 30-day mortality was 27% (82/298). Survival was 80%, 57% and 49% at five, 10 and 15 years, respectively. For survivors at the latest follow up, freedom from moderate or severe aortic regurgitation (AR) was 93%, 84% and 72% at five, 10 and 15 years, respectively. Four patients had severe AR but were not reoperated on. Among 200 patients discharged, 13 (6.5%) were reoperated on for severe AR, with an operative mortality of 15% (n = 2). Freedom from aortic valve replacement was 97%, 92% and 84% at five, 10 and 15 years, respectively. Cox regression analysis identified age < or = 59 years (p = 0.0201) and 'low-volume surgeon' (p = 0.0004) as risk factors for recurrent moderate or severe AR. CONCLUSION: The study results showed that, when the aortic dissection involves the aortic root, supracoronary replacement of the ascending aorta with a root reconstruction allows preservation of the aortic valve in the majority of patients, with a satisfactory long-term outcome.
Authors:
Alessandro Piccardo; Tommaso Regesta; Stefano Pansini; Angelo Maria Dell'Aquila; Giovanni Concistr?; Luigi Martinelli; Giancarlo Passerone
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The Journal of heart valve disease     Volume:  18     ISSN:  0966-8519     ISO Abbreviation:  J. Heart Valve Dis.     Publication Date:  2009 Sep 
Date Detail:
Created Date:  2010-01-26     Completed Date:  2010-03-02     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9312096     Medline TA:  J Heart Valve Dis     Country:  England    
Other Details:
Languages:  eng     Pagination:  507-13     Citation Subset:  IM    
Affiliation:
Division of Cardiac Surgery of San Martino University Hospital, Genova, Italy. alessandropiccardo@gmail.com
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aged, 80 and over
Aneurysm, Dissecting / mortality,  surgery*
Aortic Aneurysm / mortality,  surgery*
Aortic Valve / physiopathology
Aortic Valve Insufficiency / epidemiology
Female
Follow-Up Studies
Heart Valve Prosthesis Implantation*
Humans
Male
Middle Aged
Reoperation / statistics & numerical data
Risk Factors
Young Adult

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


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