Document Detail

Mid-term follow-up of aortic root remodelling compared to Bentall operation.
MedLine Citation:
PMID:  11343939     Owner:  NLM     Status:  MEDLINE    
OBJECTIVES: Aortic valve sparing with root remodelling has proven useful in cases of aortic regurgitation secondary to ascending aorta disease. An excessive rate of re-operation for recurrent aortic regurgitation after this conservative approach might compensate the prosthesis-related risk of the Bentall operation. METHODS: From January 1995 to September 2000, 69 consecutive patients with aortic expansive aneurysm and concomitant aortic valve disease, were submitted to the Bentall operation (group A, n=37) in the presence of an abnormal valve, or to root remodelling (group B, n=32) in cases of secondary aortic incompetence. One patient in group A and four in group B had Marfan syndrome. The follow-up was 1021 patient-months (range, 1-68 months) in group A and 926 in group B (1-64 months). The event-free survival was calculated using the Kaplan-Meier method, and the difference between curves was evaluated using the Mantel-Cox log-rank test. RESULTS: The operative mortality was 5% in group A and 0% in group B. One patient died at follow-up in group A and none in group B. Four patients (three Marfan) in group B were re-operated on because of recurrent aortic regurgitation. The 5-year event-free survival was 88+/-7% in group A and 82+/-8% in group B (P=0.58). Early residual aortic regurgitation remained stable over time only in patients with good early results. CONCLUSIONS: Mid-term follow-up failed to reveal statistically significant differences in the clinical outcome between remodelling and the Bentall operation. Our results support the widespread use of root remodelling, provided that an indication to this conservative approach is achieved after careful, case-by-case evaluation. A good early operative result is likely to remain stable over time.
C Bassano; G M De Matteis; P Nardi; M M Buratta; J Zeitani; R De Paulis; L Chiariello
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery     Volume:  19     ISSN:  1010-7940     ISO Abbreviation:  Eur J Cardiothorac Surg     Publication Date:  2001 May 
Date Detail:
Created Date:  2001-05-09     Completed Date:  2001-08-23     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  8804069     Medline TA:  Eur J Cardiothorac Surg     Country:  England    
Other Details:
Languages:  eng     Pagination:  601-5     Citation Subset:  IM    
Department of Cardiac Surgery, Tor Vergata University, European Hospital, 700 Via Portuense, 0149, Rome, Italy.
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MeSH Terms
Aortic Aneurysm, Thoracic / complications,  surgery*
Aortic Valve / surgery*
Aortic Valve Insufficiency / complications,  mortality,  surgery*
Follow-Up Studies
Marfan Syndrome / surgery
Middle Aged
Postoperative Complications
Survival Analysis
Treatment Outcome

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

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