Document Detail


Long-term survival and complications after composite graft replacement for ascending aortic aneurysm associated with aortic regurgitation.
MedLine Citation:
PMID:  1934424     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The Bentall operation was performed in 44 patients between March 1972 and December 1988. Twenty patients had stigmata of Marfan's syndrome, and 15 had aortic dissection. All showed annuloaortic ectasia. Follow-up ranged from 1 to 16 years (mean, 5.8 years). There were six early deaths (14%) and seven late deaths (16%), with actuarial survival at 10 years of 65 +/- 8%. The late deaths were mostly related to aneurysms occurring in the remainder of the aorta. No patient has undergone reoperation related to the composite graft, but six patients required seven subsequent operations on the remaining aorta. The actuarial probability of freedom from late death and subsequent operation at 8 years was 64 +/- 9% for the operative survivors, but it was 44 +/- 17% for the patients with aortic dissection and 37 +/- 19% for those with Marfan's syndrome. Postoperative angiography performed 3-168 months (mean, 42 months) postoperatively in 23 nonselective patients demonstrated recurrent true aneurysms at both or one of the coronary ostia (seven), persistent dissection distal to the distal aortic anastomosis (five), pseudoaneurysm at the left coronary ostium (one), pseudoaneurysm due to a small leak at the proximal aortic anastomosis (one), and partial dehiscence of the distal aortic suture line (one). Composite graft replacement carries a potential risk of various late complications. Our data support the concept that earlier detection and aggressive treatment of the late complications occurring in the remainder of the diseased aorta is necessary to improve long-term survival after the Bentall operation.
Authors:
K Taniguchi; S Nakano; H Matsuda; R Shirakura; K Sakai; N Okubo; R Matsuwaka; H Shintani; T Takahashi; M Mitsuno
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Circulation     Volume:  84     ISSN:  0009-7322     ISO Abbreviation:  Circulation     Publication Date:  1991 Nov 
Date Detail:
Created Date:  1991-12-16     Completed Date:  1991-12-16     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0147763     Medline TA:  Circulation     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  III31-9     Citation Subset:  AIM; IM    
Affiliation:
First Department of Surgery, Osaka University Medical School, Japan.
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MeSH Terms
Descriptor/Qualifier:
Actuarial Analysis
Adult
Aneurysm, Dissecting / complications,  mortality,  surgery*
Aortic Aneurysm / complications,  mortality,  surgery*
Aortic Valve
Aortic Valve Insufficiency / complications*
Blood Vessel Prosthesis*
Female
Heart Valve Prosthesis*
Humans
Male
Marfan Syndrome / complications*
Postoperative Complications / mortality
Suture Techniques
Time Factors

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


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